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How to Answer the Dreaded Question, “Do you Accept my Insurance?”

The question that comes up over and over again, “do you take my insurance?” This is a leading question coming from new patients and existing patients alike. So here is the thing, it’s a question at the forefront of the patient's brain, because their insurance has programmed them into thinking they must go to an in-network provider. But that is simply not the case, and insurance is probably not even the most important thing to them in a dental practice.

So how do we answer this question in a way that satisfies the patient's answer, but reframes the insurance-based thinking, and shows the patient the value of our practice? Here’s how:

Don’t make the insurance a focal point. Satisfy the question, but don’t overcomplicate the answer. Patients simply don’t understand insurance and just want to know that they can utilize their benefits. Connect with the patient first, make that your focal point.

Reframe insurance-based thinking. To reframe insurance-based thinking, you really need to understand why you are an unrestricted provider, and what your goal is as a practice. What are the core values of your practice that the patient will feel when they come to your practice, or that they already know to be true? Is your main core value compassion, optimal patient care, great patient experience? Know what value you have to bring to the patient. Also, a helpful point to know is why you are not in-network with the insurance company, especially if you recently went out-of-network with a specific insurance company.

Know the details. It is important to know what insurance companies do not have out-of-network benefits. These are typically state plans purchased through the marketplace, Medicaid, and some Medicare supplement plans. Know the specific names of each. An easy way to find out is to ask, “is your insurance plan through your employer?” Also note those insurances who will send the check to the patient. You will want to make the patient aware of your policy on these. Patients simply just want to know what to expect.

Show the patient the value of your practice and reassure them they have called the right place. Insurance is confusing and typically patients do not fully understand it. What patients do understand and what is more important than insurance to many patients is the care that they will receive at your office so let them know what the value is. This goes back to your core values, your clinicians, your advanced technology, the patient experience. This is everything! Patients will typically tell you what is important to them in a new patient call, what they are really looking for when you get past the insurance questioning. Find out what they are looking for and reassure them that your practice can provide that for them. Reassure them that you have served many patients with needs just like theirs.

Here’s a simple formula to answer “do you accept my insurance” while hitting all the above mentioned points.

We are considered an unrestricted provider. This means that we focus on providing you with optimal care (and/or enter core value here). We will still file with your insurance for you and find that most insurance companies do still provide you with reimbursement. All or many of our patients chose to come to us as an out-of-network provider because of the care that they receive (and/ or enter core values here).

Here’s what it looks like more detailed and played out in a new patient scenario:

Patient: Hi, I am new to town and looking for a new dentist. I will tell you I am a little nervous about getting an appointment but know I need to. I was wondering if you accept MetLife insurance?

Team Member: connect first- Welcome to town! I’m glad you called. How are you liking the city so far?

Patient: I love it! There is so many fun things to do here.

Team Member: So glad to hear that! So, to answer your question we are considered an unrestricted provider. This means that we focus on providing you with the optimal patient care, not dictated by insurance. We still file with your insurance for you. Typically, you will have the same maximum allowed. We have several patients that chose to come to us with MetLife as an out-of-network provider because of the care that they receive and the compassion our team has for patients who are fearful. We have many patients who have felt nervous just like you. I can assure you each team member and the doctor will make it their top priority to make sure you are comfortable during your visit. For your first appointment we would schedule an hour visit with the doctor. We do have an opportunity to see you this Monday at 3pm, or I can look another day for you?

Some other helpful info to have answers ready for:

Do you accept Delta Dental? (or any insurance that reimburses patient)”

We do file with Delta. Delta pays differently than most insurance companies. They will send the insurance check to the subscriber/you. We collect in full at the time of service and will still file the claim for you. You will receive the insurance check typically two/three weeks later and then keep that as your reimbursement. If you ever have any issues receiving payment from them, be sure to let us know and we will be happy to help.

“Do you accept Medicaid?”

Unfortunately, we do not. We would be happy to have you as a patient, but you would be a cash patient at our office. If you would like to find an office where you can utilize your benefits, there should be a phone number or a website on your card where you can go and enter your zip code to find providers in your area. If your insurance ever changes be sure to call us and check again!

(Make sure to know your state law and know if you are legally allowed to see Medicaid patients as cash patients)

Use this answer to extend goodwill. You will be shocked on how many of these patients will remember your kindness on this call and call you back to schedule when they no longer have Medicaid.

If you are looking at going out-of-network with insurance companies and need a step-by-step guide on what moves you need to make to ensure a successful transition then check out this free resource:

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