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.