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Dental Insurance Explanation Brochure for Patients

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As I have stated previously, it is imperative to strive for the collection of accurate co-payments on the date of service.  Many dental offices choose to bill after receiving insurance payment.  Some make an attempt at co-pay collection simply by calculating a percentage of the total fee assessed.  Most patients believe that the estimate they have been given and the co-pay they initially submitted reflect the actual balance that they will owe.  I know how I feel when the auto mechanic provides me an estimate prior to dismantling my vehicle and then surprises me with a much larger bill after the work is completed.  I understood at the time that I was being given only an estimate, but my frustration at receiving such a high bill quickly overwhelmed that understanding.  In order to get my vehicle back, I will need to pay this higher than expected bill.

Patients react in a similar manner when opening the bill from your office reflecting what their insurance did not pay.  They generally believe they have already paid what they owe and that you are now overcharging them.  This belief is further compounded when they receive the estimation of benefits from their insurance company explaining how your fees are remarkably higher than UCR.

Dental insurance benefits are confusing and disappointing to many patients who are accustomed to the more extensive and often clear cut benefits provided by their health insurance company.  The common insurance company practice of downgrading treatment and the incredibly low yearly benefit maximum are two factors that really surprise patients.  In order to lessen the shock our patients might feel from the disparity between the perception of their insurance and the reality of what it does not cover, we designed a dental insurance explanation brochure from questions that we frequently heard our patients ask.  This brochure, entitled Understanding Your Dental Insurance Benefits, has been extremely helpful in conveying some of the limitations of dental insurance plans to our patients.

 The patient dental insurance explanation brochure clarifies in laymen’s terms some of the most misunderstood features of a dental plan.  The veil is lifted from the infamous UCR, or Usual, Customary and Reasonable, which dental insurance companies often employ to depict to patients why a doctor’s fees may be higher than those of the insurance company.   PPOs and in-network versus out-of-network benefits are described. Pre-existing conditions such as the missing tooth clause are discussed.  Frequency limitations, deductibles, percentages covered, yearly maximums, treatment exclusion, wait periods and alternative treatment covered are all addressed as well.  We conclude the brochure with wording indicating how we can help the patient utilize the particular coverage to get the most from the plan, and that the co-payments will be calculated with the greatest degree of certainty that the insurance plan’s available information will allow.  We also invite the patient to feel free to ask us any questions regarding concerns about insurance benefits.  The Understanding Your Dental Insurance Benefits brochure can be found in its entirety on our dental Practice Management CD.

You can purchase this valuable CD buy clicking “Add to Cart” below.

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Jan 12, 2012 | 3 comments | View Post

Case Acceptance–Getting Your Treatment Plans Scheduled

Treatment plan presentation will vary in methodology from clinician to clinician. Conversion success rates are not always consistent with the type of methodology implemented. One thing being clear, however, is that it is imperative that the clinician effectively communicates how having the outlined treatment completed will benefit the patient.

 

Experience has taught me that most new patients are skeptical that the dentist is there to take my money, and are leery of aggressive treatment planning on the first visit. I do not refrain from comprehensive treatment planning and I always make sure to completely inform the patients of their needs. I just do not feel the need to sell them the entirety of an overwhelming treatment plan on their first visit. I educate them and encourage them to select the treatment that I know is best for them. They need to trust me before they will buy what I am selling.

 

Because we are obligated to inform our patients of all oral health concerns we diagnose, we must at the very least disclose the defects we see clinically. This can be done quite appropriately in about 90 seconds, even when considering extensive treatment plans. This does not mean that you are required to provide a financial arrangement to the new patient on the first visit which dictates all the money owed for the entirety of the treatment outlined.

 

Logically, we are not going to do all the treatment at once anyway, so suffice it for us to disclose the fees associated with the initial phase of treatment. This commonly means the treatment that gets the patient out of pain or that which is in greatest need of immediate attention. Sometimes it is the treatment that the patient desires most, or the patient’s chief complaint.

 

This approach serves to gently escort your patients into the comfortable environment you have established for them without requiring them to push a wheel barrow full of cash to the doorstep before being allowed entry. You goal is to eventually care for all of your patients’ treatment needs. You will stand a better chance of doing so if you simply do not give them the whole enchilada on the first visit.

Dec 20, 2011 | 1 comment | View Post

What’s Your Dental Office Collection Percentage?

303/365 Catchup
Creative Commons License photo credit: thebarrowboy

All dentists should be acutely aware of the collection percentage in their dental practice and review it on a monthly basis.  The collection percentage in my dental office in an average month will hover around 99%.  We very rarely send patients to collections because we work hard to calculate accurate co-pays and collect payments at the time of service.  I would estimate that less than .01% of my patients ultimately require collection proceedings.  This ratio stands in stark contrast to a practice in which I once associated.  In this practice, it seemed that nearly every other account went to collections.  It was so common that the office manager once informed me that many of their patients simply pay the collection agency and then schedule another appointment.  My experience with these types of accounts, however, has been that once a patient goes to collections, the patient chooses another dentist to dole services.

 

Interested to learn what the specific collection percentage in this practice was, I inquired this data of the office manager.  She seemed knocked off balance initially, though my intent was merely one of curiosity and not one of judgment.  She quickly filled the void in the air with the response, “Around 93%.”  I thought she may not have been certain about that number, but that it had sounded good to her and a collection percentage about which a dental practice should be proud.  I would caution you not to be so pleased with a collection percentage of that order in your practice.  It would behoove us all as business owners to have the number that accurately reflects our true collection percentage at the ready in our minds as well.

 

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Let’s look at an example of what not collecting that 7% of produced income would do to our bottom lines if our collection percentage was at that seemingly respectable level of 93%. As the math will bear out, a 7% neglect in collections will in reality amount to a 17.5% reduction in your take home pay.  Now let me ask you, would any of your employees come to work for nearly 18% less money per year?  If so, they are likely being paid way too much.

 

In this hypothetical example, let’s set our yearly production at $500,000.  We’ll assume a reputable overhead percentage of 60%, though I am convinced that you can have an outstanding practice with an overhead closer to 50% without too many changes.  Dentistry’s Business Secrets outlines in greater detail the various means by which to achieve The Low Overhead Practice.  In our example, your take home pay after overhead of 60% will be $200,000 per year.  This, of course, is assuming you collect 100% of that which you produce.  When collections are off by the purported 7%, the bottom line take home pay is automatically reduced by $35,000, or, 7% of the $500,000 you produced.  Therefore, your salary is no longer $200,000 but $165,000.  That $35,000 you left on the table is equal to 17.5% of your original salary after overhead.

 

This brings me to the topic of free money.  I look at that $35,000 of failed collections as free money.  Since we all realize how hard the job of dentistry is, we know that this money does not truly come for free.  The fact is you have earned it.  I want to see you keep it!  This was a big reason for why I wrote Dentistry’s Business Secrets in the first place; to help you collect and keep your hard-earned money.

 

Another way to view the money we lose when we fail to collect what we produce is in the amount of labor necessary to regain this lost income.  If we collect the extra 7% we discussed, we get to keep 100% of that $35,000.  This money is not subject to overhead expenses, because overhead is calculated as the ratio of expenses/production.  Lost collections is not an overhead expense per se, it is in addition to overhead.  In order to receive that full $35,000 in our paychecks, we would need to produce $87,500 more than if we simply collected it from our patients and the insurance companies who owe it to us.   This is simply because whatever we produce is subjected to overhead expenses and what we collect is not.

 

Obviously, the greater the production value in your practice, the more negatively failing to collect will affect your bottom line.  In turn, the harder you will need to work in order to produce the money lost to insufficient collection techniques.  Take heart though, there are tried and true methods that can be easily implemented into one’s practice to ensure collection numbers closely approximating 100%.  You have earned it, so it stands to reason that you should be able to receive it and then do with it as you so choose.

Dec 13, 2011 | 2 comments | View Post

Dental Treatment Planning Lessons

Recently I fielded a question from a concerned client regarding the way in which an associate dentist was treatment planning his patients. The question and answer are presented below:

Dear Dr Logan,
Kudos on a great book. My question to you is, how do you
motivate a clinically great dentist with no business sense? Two and half years into private practicing he is still treatment planning based on what he ‘thinks’ patients can afford. Can you direct me to a resource to help me help him? Thanks for
your help.

Thank you for your inquiry. The best resource I can give you is an answer from personal experience. I have had associates in the past who maintained this style and the best way to redirect their thinking was to have a dedicated sit down with them and spell out the reasons why this thinking is not good for the patients and not the way people who are seeking treatment in your private practice would like to be treated.

For example, treating problems with patchwork dentistry almost always requires further, more extensive and more expensive treatment down the road. This happens sooner than five years in most cases. Therefore, when we fail to provide optimum care up front, the patient will be saddled with redoing inadequate restorations (such as large fillings when crowns were the ideal long-term solution) or even losing teeth that could have been saved. No patient wants this, and no one wants to pay for things twice. These things happen in patchwork practices all the time.

You should point out your degree of experience, which is bound to be greater than your associate’s, which reveals the failure with these restorations. People are coming to you for the best you can give them, so the associate needs to understand that not providing this is failing the patient. Presenting your case in this manner will enlighten your associate doctor as the benefits to the patients of treating with optimal dentistry and relieve you of the impression that you are merely out to increase your profit.

I hope you have found this information helpful. Best of luck with this and please follow up to apprise me of the results you will obtain from this.

Kind regards,

Ed
 
One thing to always impart to your patients when discussing treatment needs is that there will never be a time again that will allow you to treat more conservatively and more affordably than optimally treating the condition right now.

Dec 05, 2011 | 0 comments | View Post

Checking Dental Insurance Maximums

It’s that time of year again when dental offices need to be extra diligent about checking for dental insurance benefit maximums when creating dental treatment estimates.  Remember that your patients may have had dental work done at a specialist’s office and may have used some of their benefit allotment there.  For example, a patient who visited an oral surgeon may be out of insurance benefits by this time of year. It’s important for the person who creates treatment plans to be aware of the patient’s remaining insurance benefits in order to factor in any additional cost that might not be covered by insurance.

 

As I discuss thoroughly in Chapter 18 of Dentistry’s Business Secrets: Proven Growth Strategies for Your New or Existing Practice, it is extremely important to figure and collect accurate co-pays.  Too many dental offices rely on guesstimates based on a flat percentage of coverage without factoring in deductibles, remaining benefits and UCR.  This is the difference between making sure you get paid for your work immediately or having a staff member spend countless hours tracking down remaining balances and the risk of angering your patients who receive an unexpected bill.

 

To make the insurance verification process smoother, my business manager created a Dental Insurance Benefit Checklist which is included on the Dentistry’s Business Secrets’ Dental Practice Management CD.  Also, included on this CD is the wording we include on all of our treatment estimates which informs patients that we have tried to calculate an accurate co-pay estimate, but due to the limited information provided by the insurance company there may be a balance remaining.

Oct 04, 2011 | 1 comment | View Post

Treatment Planning for Dental Nightguards

I Don’t Need a Nightguard!

This scenario presented itself in my office just yesterday.  I had a patient who admittedly grinds her teeth and shows moderate to advanced wear on all her teeth.  I have recently lowered my dental nightguard fee in an effort to get more of the patient population in need to schedule this treatment.  Her excuse was that if she had the money sitting around somewhere, she would do it.  I shot a quick glance at her Louis Vuitton handbag resting in the chair and the BlackBerry smartphone she couldn’t resist but to answer and had to wonder.  When she finally revealed that she would be taking a two week vacation to Florida next week, my suspicions were confirmed.  It wasn’t that she did not have the money.  It was that I apparently did not do a sufficient job in convincing her of the value of the nightguard and of her real need for it.
So this begs the question: What do you do in your practice to gain treatment acceptance for occlusal guards?

Dec 10, 2010 | 1 comment | View Post

How Do We Treatment Plan the “Baby Boomer”?

The “longevity” factor of our patients cannot be overemphasized when it comes to our treatment planning.  We would be remiss in our examination process if we were determined to diagnose the pocketbook and not what the patient (read, Baby Boomer) might want.  Calculations for retirement plans are now being performed based upon the expectation that the retiree will live to be 100 years old!  Baby Boomers know this and are trying to plan for the welcomed eventuality that this occurs.  Therefore, they are valuing their teeth for a lifetime and not opting for the extraction as often as I have witnessed in my practice life.  I am reminded of a quote from history,

“Every tooth in a man’s head is more valuable than a diamond.”

Miguel deCervantes, Don Quixote, 1605

Oct 11, 2010 | 0 comments | View Post

Getting to “Yes” for Esthetic Dentistry Treatment

Even though we may want to drive the sale of cosmetic dentistry to our patients, it is generally more profitable to allow the patient to take the wheel in this process.  The idea is to balance the notion of investigating what the patient really wants without “selling” the patient something she does not want. Fleshing out true desires is an art.  I have been disappointed at times when the desire for esthetic improvement was primarily my own and not the patient’s.  When this is the case, the patient tends to be even more critical of the work and more difficult to please.  Tread lightly with the patient who was actually “sold” cosmetic dentistry, I would caution.  Be sure to present all available cosmetic improvement options you can provide and then let the patient “buy” the treatment from you.

Oct 07, 2010 | 4 comments | View Post

Laser Cavity Detection for Dentists

Today’s technology now permits dentists to diagnose dental decay with increased accuracy through the use of a laser.  The Diagnodent laser cavity indicator provides a handheld wand which the dentist can use in a manner similar to the traditional explorer instrument.  Instead of “picking” into the tooth, the wand is waved over the tooth and an audible tone is emitted when decay is detected.  The tone increases in intensity in tandem with the depth of the cavity.  A digital numeric reading is also displayed, consistent with the degree of the decay.

With the increased prevalence of fluoridation of water sources has come the propensity of teeth to mask or seal over actual decay.  Therefore, the surface of the tooth being probed with an explorer may read as healthy tooth structure, while the underlying tooth is actually being consumed by soft decay. The laser allows penetration through the superficial layer of the tooth and thus captures the true health of the tooth structure below.  This invention, though unfortunate for the patient hoping to escape the appointment cavity free, has enabled the dentist to treat cavities in their early stages, before a root canal or tooth extraction becomes necessary.  The dental laser for cavity detection is just one more tool in the arsenal of the dentist looking to provide preventative dentistry.

Apr 08, 2010 | 1 comment | View Post

Building Trust in Your Dental Patients

       In the end, a patient’s decision to schedule proposed treatment is all about trust.  This trust relationship begins well before the patient ever enters your office door.  It begins with the initial exposure a patient has to your practice, whether in the form of a postcard mailer or by way of referral from a friend or family member.  It continues to develop through the new patient phone call and expands via the guest mentality your staff extends upon arrival.  The relationship grows with the gentleness and concern afforded by your hygienist and progresses further by means of displaying your own honesty and integrity.  This bond matures over time through the consistent care and attention imparted by your staff and the painless, quality dentistry you reliably provide.

       You can employ the best treatment plan coordinator in the world, but it is ultimately the doctor who is responsible for convincing the patient of the necessity for treatment.  The dentist is the office staff member most trained and knowledgeable in the importance of oral health care procedures.  This is not to overlook that many practices successfully schedule dentistry based solely upon the salesmanship of the treatment plan coordinator.  It is to say, however, that these practices will never be as productive as they could be with a doctor who educates, inspires and elicits the trust of the clientele.

       One way to cultivate this trust is to be wary of handing the new patient an overzealous treatment plan on the initial visit.  While we are obligated to diagnose and present all oral health needs to any patient seeking our expertise by way of a comprehensive exam, certain procedures can obviously be prioritized over others.  Nurturing a trusting relationship over time seems to result in the greatest cosmetic dentistry and comprehensive treatment plans being accepted.  Most people take some time to develop trust, and they quite often require multiple six-month recall appointments before they are ready to sign up for those beautiful veneers you have awaiting them.  Do not oversell them.  The fact that they are in your chair is evidence that they want to trust you.  Give them every reason to do so.  With time, they will be requesting the treatment from you, their new friend. 

            This principle of establishing trust eclipses every other form of internal marketing you can extend your patients.  This is the real internal marketing.  The attractiveness of this form of marketing is that its effects are consistent no matter what type of practice you have chosen to operate.  The real beauty, of course, is that the fiscal cost of this manner of marketing is zero.

Mar 22, 2010 | 0 comments | View Post