Question: Can you provide any advice for getting out of network with dental insurance?
We opened 13 years ago and were initially in network for all PPO insurances and we have now decided to get out of network with insurance. I know you have mentioned in your videos that your offices are out of network with most insurance companies. Are you also out of network with Delta Dental? In Wisconsin, if you are out of network with them, they mail the check directly to the patient. Do you deal with this and if so, how? I am fearful of how to handle this transition. Can you offer any advice but specifically on how to handle checks getting mailed to patients? I appreciate all the advice you can offer as we transition to a fee for service office.
ANSWER: Here are a few of my suggestions:
- ) Get involved with the Facebook Group, Fee For Service Dentistry, started by Dr. Drew Byrnes and look up his Fee For Service Podcast. Both of these will be great resources as you move forward down this path.
- ) The next thing is to train your team on this change and how to explain the change to the patient. You want to give your team the confidence by being confident yourself with these points. If the team presents this as if it is not a big deal and that there is nothing to be concerned about, then the patient will be more likely to be okay with the updated change.
Here are a few key points:
- It is not your decision to have the checks go to the patient, it is the way that Delta does it and there is nothing you can do to change it. Make sure the patient understands that with most other insurances, the checks can still go to you but since they have Delta, it has to go to them. You want it to be clear that the reason is because of Delta and not your office.
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- You want to spin in confidently by giving the patient the positives of this. Ultimately, the patient is the client of the insurance company, not the dental office and because of that, the insurance company wants to keep the clients happy whenever possible. Therefore, many times when they see that the check is going to the patient and not the dental office, they may approve more without pushing back as much and they pay faster.
- Your office will still submit all that is needed to get the claims paid, just as you always have done and will follow up with the insurance if there are any delays or they need more to process the insurance claims. This all must be done to make sure the patient gets paid.) Role Play this with your team until they each can have this conversation comfortably and confidently with patients. You don’t want them quoting a script but instead, make sure they can comfortably explain in their own words.
3. ) Role Play this with your team until they each can have this conversation comfortably and confidently with patients. You don’t want them quoting a script but instead, make sure they can comfortably explain in their own words.[/mepr-active]