Insurance will not fix the woes in your dental practice
Is your dental practice too reliant on insurance? Or did your practice take on more insurance companies to try to "fix" a slowdown of patients? Insurance is not the answer, and here's why.
If you work in the dental industry, YOU WILL INEVITABLY DEAL WITH INSURANCE and insurance companies, no two ways about it. Insurance is part of the foundation of dental office life, day in and day out, just like last-minute cancellations, gum disease, tooth decay, and patients running late to their appointments. Insurance is a regular part of our job, whether we love it or hate it.
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Many times, dental offices join an insurance network to get new patients and provide value to patients. But they usually join with the intent of eventually getting out. But as the practice grows, so does its dependency on insurance. Yes, patients rely on insurance, but I’m not talking about the patient’s dependency; I’m referring to many dental offices’ dependency on insurance.
I think too much of anything is never good, and that’s true of insurance in dentistry. If your office has become too dependent on insurance or if your client interactions are too focused on insurance, then it’s hurting you more than helping you.
Here are five ways dental offices can recognize their dependency on insurance, and how to fix it.
1. New patient call
Patients are calling our offices because they need a dentist, but they often don’t know what to ask us. They start by asking if we take their insurance. We need to address that question, but first we need to address the person on the phone. We need to find out the real catalyst for their phone call and how we can help them before we start the insurance question and answer game. Phone staff should be trained not to bring up insurance first! Too many offices have become so focused on it that they forget there is a person with a name and dental needs on the other end of the phone. Don’t let insurance get in the way of your first contact with a new patient.
2. Treatment plan creation
Does your office look to see how much patients have remaining on their insurance benefits for the year before developing their treatment plans? If so, your office has a dependency problem. Let’s just say a patient clinically needs three crowns, no question, but the insurance is only going to cover one crown this year. A typical office would then put a plan together with one crown and put a “watch” on the other two. Is that what’s best for the patient, or is that what’s best for the insurance company and your office? Think about it—the insurance company saved money and your office got paid for one crown, but how did the patient benefit from this approach? Insurance companies may not be willing to cover every aspect of treatment, but remember, they are making business decisions about their bottom lines. Your office is responsible for clinical decisions about patients’ health needs.
3. Treatment plan presentation
How often does this happen at your dental office? You show patients a treatment plan and then tell them what the insurance will cover and what their out-of-pocket expenses will be, then you ask them what they want to do. Frankly, this is like sitting a four-year-old in front of a huge plate of broccoli and asking her what she wants to do. Sure, there are a few kids who like broccoli and will choose to eat it, just like you have some patients who make treatment decisions based on their dental health, regardless of what their insurance covers. However, most people will go with the easiest option. If we let insurance dictate what procedures patients should have done, patients will always choose the procedures the insurance will cover, until they max out their benefits.
4. Negotiating insurance fees
When you sign up with an insurance plan, your office agrees to take a reduction in fees in exchange for being listed in the company’s list of providers. No one likes to work for less than they’re worth, so whenever possible it’s important to get paid more. It makes sense to be familiar with the plans you’re in and to make sure you’re attempting to get paid more whenever the insurance plan allows you to negotiate your fees. However, I don’t think you should depend on that method to fix your practice in a big way. The amount of time and effort it takes to have the insurance company come back with a $1 higher allowed fee on a prophy is not as effective as spending the same amount of time focused on patient care, asking for referrals, calling patients with outstanding treatment, or any other numbers of ways to bring in more revenue.
5. Joining more insurance networks to fix the practice
I do not think joining insurance plans is necessary to grow a practice from scratch. However, if your office has already joined, then it’s too late, but do not join more companies. I’ve spoken with many dentists over the years who had a bad quarter and didn’t know what to do about it, so they joined more plans. The result? Not even one has been happy with the outcome. They found they didn’t get a huge number of new patients and they ended up seeing more of their current patients but at a reduced fee because of being “in network” for their plans. More insurance will not fix the problem of being slow, and it’s a poor substitute for marketing your practice.
Insurance is a necessary evil in dentistry and we must learn how to deal with it, but we don’t have to let it dictate our businesses. At the end of the day, what will help your practice and your patients is to offer superior customer service and exceptional dental care, employ and continually train great team members, implement systems that work, and market to find more quality new patients. Focus on those areas and you will see results.
Want to read more about how to manage insurance and insurance issues in office? We encourage you to enroll in our course "Dental office or clinic management. Unleashing business potential" by Laura Nelson.