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Does Accepting Insurance Help or Hurt My Dental Practice?

Posted by Erick Cutler, CPA on Jul 20, 2020 9:15:00 AM

Cash flow is top of mind among dentists during these difficult days of COVID-19. Practices remained open only for emergency procedures this spring, with all routine procedures canceled or postponed. Even as offices reopened for full service, patients have been slow to reschedule appointments due to safety concerns.

Marketing your practice to increase revenue is paramount. Many dental practices look to insurance as a way to offset lower revenues, but is it always the wisest decision?

Overview

Insurance can often be a source of frustration for dental practices and their patients. For example, patients may find that their dentist accepts a particular carrier, but only specific plans within that carrier. For dentists, are reimbursement levels worth the time it takes to train staff, submit claims, and follow up on those claims? On the other hand, you may not want to turn away business or lose patients, especially during these challenging times. And if you have a new practice, insurance offers a way to build business.

Putting Patients First

Understandably, the first thing potential patients want to know is whether you accept their dental insurance. It’s important to answer the question, but make a point of understanding the purpose of their call. After assessing the individual’s needs, it’s possible that you will be able to develop a treatment plan that meets their needs, with or without insurance. Once you get a new patient, the plan should not be guided solely on what insurance covers. Delaying treatment because the plan will only cover part of their immediate needs isn’t going to serve your patient well in the long-run.

Staff Considerations

Some dentists no longer accept insurance plans because of the drain on their staff. Your front office will be relieved from time-intensive billing and accounting procedures associated with reimbursement. Instead, you collect from patients up front, and the patient’s provider will reimburse for services rendered. For the most part, you have removed yourself from the equation. You still must provide patients with all the information they need to be reimbursed, such as statements and ADA codes.

Out-of-Network Alternative

You will undoubtedly lose patients if you decide that you will no longer contract with carriers. If economically feasible, you may want to provide patients with payment options or a discount for a combination of services. Most insurance plans allow insured patients to visit out-of-network dentists. The patient just has to pay up front for services and wait for reimbursement from their insurance company. You can also choose to file for the patient as out-of-network. In most cases, you will receive some payment from the insurance carrier, which you can use to slightly lower the patient’s bill.

Phase Out Slowly

Do you participate in several PPO networks? It may be a good idea to phase out slowly to mitigate a sharp drop-off in the volume of patients. Stick with the carriers that provide the best service and slowly drop the others. Always remember to communicate with your patients well in advance, so they understand your plans.

Communication is Key

Be vigilant about following up with patients whose care was interrupted because of the pandemic. Emphasize the steps you are taking to ensure their safety and communicate everything you’re doing according to ADA and CDC guidelines. Make goodwill calls to inquire about their health. You’d be surprised how many patients will schedule their postponed appointment when they receive one-on-one empathetic communication. Knowing that the dentist is on their side is extremely reassuring to patients, and will keep them coming back.

See related blog: Tips on Reopening Your Dallas Dental Practice During COVID-19

Above all, focus on the patient experience. Treat your patients well, provide great results, and you’ll likely get referrals. Patients value good relationships with their healthcare providers.

To learn more about managing cash flow for your Dallas dental practice, or implementing dental practice efficiencies that will help grow your practice, contact the dental CPAs at Goldin Peiser & Peiser or Erick Cutler at 214-635-2541.

Note: This content is accurate as of the date published above and is subject to change. Please seek professional advice before acting on any matter contained in this article.

Topics: Dental, Healthcare, Insurance, PPO