Your Dental Insurance Benefit Questions Answered

As dentists, we play a pivotal role in helping patients understand and maximize their dental insurance benefits. By maintaining open and clear communication, we provide invaluable guidance for their oral healthcare goals. Plus, we establish a clear policy of retention that treats patients like people, not numbers. A proactive approach to discussing available treatment options, cost estimates, and details of insurance policies not only empowers patients to make informed decisions, but also fosters trust and confidence in your practice. Let’s explore a few strategies to help engage in productive conversations with patients about best utilizing their dental benefits.

Understanding a dental insurance benefits plan

Most insurance policies aren’t the easiest documents to understand, and it can be difficult to find out exactly what’s covered and by how much. You can have your dental accounting staff explain the monetary amount left on benefits before they expire at the end of the year, typically within the first week of January. Don’t assume that the plan will roll over any excess benefits that the patient may have. It’s also important to take what patients say and think their insurance will cover into account when planning long term treatment, as your practice will need to consistently monitor and verify their insurance coverage in the upcoming months.

How do I know what my dental insurance benefit plan covers?

This will most likely be the most common question your patients ask. Of course, we won’t know the answer without insurance verification. Explain to patients that your practice will be able to verify:

• Benefit plan limits and maximums
• Covered and non-covered procedure costs and copayments
• Coverage dates from beginning to end

If a misunderstanding about benefits is keeping your patients from consistently scheduling, it’s time to implement a comprehensive insurance verification plan. Outsourcing this task makes for timely and effective EOBs that allow you to provide effective care at every appointment.

How can I maximize my dental insurance benefits?

Some patients are skeptical about what’s necessary to maintain their oral health. Oftentimes, they think regular brushing and flossing is enough to prevent cavities and gingivitis. Of course, dentists know that professional cleanings are essential even for those without noticeable problems. We are better able to discover worrisome signs from infection from our vantage point, which may appear in otherwise healthy teeth. Ask patients about what they see when they brush and floss.

• Are your gums bleeding when you brush or floss?
• Do you have sensitivities to sugar, hot or cold food and liquids?
• Is there any discoloration in your teeth, especially the lower molars?

Regardless of the answer, we can better explain to patients the necessity of prompt treatment for these and other concerns. Plus, educating them about what to look out for can help create an environment where your patients come to you for information, versus simply Googling it and having their concerns diminished. If your insurance verification plan is working as it should, you can also remind patients about their benefit coverage for preventative care.

What happens when you max out your dental insurance benefits?

Like with any other medical benefit, the patient is responsible for any cost that goes over the maximum limit. If you can see that benefits are expiring or heading toward the maximum, you can still recommend treatments that fit within a patient’s budget. Instead of a cosmetic procedure, tell patients that it will be more cost effective to replace an older filling or getting a new one.

If your patient is concerned about going over their maximum, having a dedicated discussion about future payment options may be in order. Ensure that you are communicating not as a salesman, but as a spokesman for your patient. Their healthcare is your specialty, and you are the one with whom they can confide in with their concerns.

The Golden Rule and patient retention

Of course, you need not wait until a patient comes to you with concerns to build out treatment plans. Between preventative care and restoration, each patient comes with unique needs. Perhaps you have a patient with a history of soft teeth and cavities. Are you lecturing them about eating hard candies, or implementing a treatment plan that cares for their unaffected teeth? It is important to remember the Golden Rule when it comes to discussing care with patients. When we treat patients as friends and family, we are giving them a version of ourselves that genuinely cares. Ask personable questions, such as:

• What concerns you the most about your teeth right now?
• What could myself or my staff do better to make you feel the most comfortable?
• Are there any personal oral healthcare goals you’d like to share with me and have me help with?

It doesn’t take a long-winded conversation to make an impact with patients. Instead, take on the role of a servant leader. Seek first to understand, then be understood. Your patients will always have the best idea as to what they want their treatment to look like. All we have to do is make sure that we listen.

Maximize peace of mind with eAssist

eAssist Dental Solutions was created by dentists, for dentists. We are here to help you on your patient retention journey and beyond. Whether you require a skillful team of dental billing specialists, scheduling help, or insurance verification, our platform suite has a solution ready. By taking the burden off of your office staff, you will be better able to maintain patient relationships. Fostering a culture of trust throughout your practice will work wonders in creating a solid, consistent patient base. Expect referrals from patients who speak about your honesty, integrity, and commitment to the craft of dentistry. eAssist can be your dedicated partner in all of your practice’s financial milestones. Schedule a consultation with a Business Development Specialist today, and you can discuss your goals for the future with us today.

Dr. James V. Anderson

CEO & Co-Founder, eAssist

Dr. James Anderson is a practicing dentist and the CEO and Co-Founder of eAssist Dental Solutions, the nation’s leading platform for dental billing. A serial entrepreneur, Dr. Anderson has built multiple successful ventures, including eAssist and nine dental practices in Utah, all driven by his mission to help dentists, their teams, and their patients achieve peace of mind. He co-founded eAssist in 2011 to give dental practice owners the ability to fully outsource their billing departments—a vision that now serves over 2,400 practices nationwide. Under his leadership, the company has formed strategic partnerships with the California Dental Association and Henry Schein, and earned a spot on the Inc. 5000 list for nine consecutive years. In 2020, Dr. Anderson was recognized as Entrepreneur of the Year by Business View Magazine and ranked among the top entrepreneurs in the country by Entrepreneur Magazine. He holds a B.S. in Finance from Brigham Young University, a D.M.D. from Oregon Health & Science University, and completed the three-year O.P.M. program at Harvard Business School. He also serves as Chairman of the Dental MBA Advisory Board at Roseman Dental School.