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Is Your Dental Office Insurance Driven, or Insurance Savvy? There’s a Big Difference

Love it or hate it, insurance is something that everyone in the dental industry has to deal with on a regular basis.

To serve our patients well, it’s vital for us to understand the ins and outs of insurance, including the details of what’s covered and not covered by specific plans. After all, when patients come to us for treatment, one of the first questions they inevitably ask is, “Will this be covered by my insurance?”

If you work in a dental office, learning the basics of insurance is a necessity.

The problem is, many offices go too far by focusing the entire framework of their patient relationships around insurance details. There is a huge difference between an office that is insurance driven versus one that is insurance savvy.

What’s the difference?

First let’s look at what it means to be insurance savvy. “Savvy” means being knowledgeable and smart about something.

For staff in any position in a dental office, this means knowing how to solve problems related to insurance and being able to maximize treatment coverage according to patients’ benefits.

Being insurance savvy means being familiar with common policies, helping patients understand how their plan works, accurately estimating what insurance will cover, and a willingness to help patients appeal if coverage is denied.

Regardless of whether your office is classified as fee-for-service or in-network for a particular plan, you need to be insurance savvy in order to complete patients’ treatment plans.

This seems like common sense, right? Every office wants to think of its team as insurance savvy. But here’s what I see happening in many offices. Over time, in their attempts to be insurance savvy, the staff gets mired down in insurance details so that it becomes their main focus, instead of patients being their main focus.

An insurance driven office is making treatment decisions based on insurance, not on what’s best for patients.

You might believe that your office is insurance savvy, not insurance driven.

To find out, check whether you’re guilty of any of these scenarios:

Scenario 1:

A new patient calls in and you welcome her to the practice. You ask her name and how she heard about you.

The very next question out of your mouth is, “What dental insurance do you have?”. What is this telling the patient about how you value her as a person when you ask that question in the first 30 seconds of the phone call? You haven’t gotten to know the person at all or even asked why she’s calling to schedule an appointment.

In the first moment of your relationship with the new patient, you’re letting her know that you prioritize her insurance coverage over her needs.

Scenario 2:

In the morning huddle, there’s a new patient’s name on the schedule. When discussing the new patient, the first question a team member asks is, “What insurance does he have?”. Another team member responds with the name of the less-than-optimal insurance carrier, and the energy in the room plummets.

Now your team has negative thoughts about working with this patient, when the only fact that has been presented about the patient is his insurance. What about other important details, like his reason for scheduling treatment, or how he heard about the practice?

Is it fair to the patient to have the entire team view him negatively or positively based on his insurance?

Scenario 3:

A patient comes in for an exam and is waiting to hear the doctor’s thoughts about the treatment plan.

The doctor’s first question is what amount of insurance benefits remain on the patient’s plan for the year. Wouldn’t this patient be justified at being upset that the doctor’s focus is on insurance instead of on her health needs? Yes, of course we want to help patients maximize their benefits. But the treatment plan should be developed based on what’s best for the patient, not on insurance benefits.

So when I say your office should be insurance savvy but not insurance driven, my point is that it’s important to remember what we’re here to do.

We’re here to take care of patients and give them the best dental care possible, not to let insurance dictate their treatment.

Honestly, is the insurance company looking out for the best interests of patients? No. That’s our job.

We have to focus on the patient relationships first and the insurance second. That’s what being insurance savvy is all about.

Laura Nelson

Laura Nelson, BS, MS, FAADOM is the founder and driving force behind Front Office Rocks, and the leading provider of on-demand virtual training and resources for dental practices.