Cusptips

Do you take my insurance?

10,540 Comments / practice Management / By

Do you take my insurance?

Patients want to know their costs for treatment and what benefits their insurance can offer at your office.

They may call your office and ask, do you take my insurance?

The reality is most dental offices can file most all insurances. But the patient also really wants to know not only does the office take their insurance, they want to know what kind of benefits their insurance will pay at your office and if there are any negotiated in-network rates to help save costs.

They want to know whether the office is in network or out of network. So you really need to know more about the types of insurance and what type of insurance this patient has.

6 types of insurance

There are many types of insurance, here are 6:

1. Open panel freedom of choice

The open panel freedom of choice insurances. With these plans, a person can choose any
dentist and any dentist can choose to participate.

2. Closed panel insurance

These plans allow the patient to only be seen by a dentist who has a signed contract with
insurance.

3. PPO (preferred provider organizations)

PPOs are preferred provider organizations and this may be a patient who has in-network
coverage, where this may with an in-network provider who has signed a contract with the
insurance carrier to charge a reduced fee for the patients.

These patients may still have the option to see an out-of-network provider, but they may pay a greater share of the full fee.

4. EPOs

EPO is an exclusive provider organization and these patients can only see an in-network dentist and there are no out-of-network benefits.

5.Capitation plans

There are also capitation plans, which could be a DHMO – A dental health maintenance organization.

Dentists in these plans are paid a monthly fee to care for the patients, but the patient has to go to a contracted dentist.

6.Medicaid

There are also plans like Medicaid that are state run plans and the benefits are paid by the state.

The insurance coverage for these has to be verified for the date of service to be sure that the patient has eligible coverage and the patient has to go to an in-network provider.

So you can see there are a lot of complexities to this question. Do you take my insurance?

And the best thing a dental office can do is to help the patient get some answers about the benefits and help them to get the care they need.

That’s what the patient wants. They want answers about their benefits and they want to get the care they need.

Understanding insurance benefits

So try to help them understand their benefits in the most transparent way and recognize that it’s not only confusing for the patient, but it can also be confusing for the office sometimes.

For example, sometimes you may hear a patient has insurance X and you don’t recognize the
name of this insurance.

You may have never heard of insurance X before, but when you call the provider relations number on the back of the insurance card, you learn this insurance X uses the insurance Y fee schedule and your office is already a participating provider for insurance Y.

This could be a third-party administrator acting on behalf of insurance X so the patient can get in-network rates with the insurance Y provider.

Even though they have insurance X, they have in network coverage at your office with insurance Y networks, it’s very complex.

So sometimes the answer of whether the office is in network with a company is way more complicated than just looking at your list of insurance participation and knowing which insurances you’re in-network with at your office.

To know which patients get in-network rates at your office, you really have to dig a little deeper and be able to explain in-network and out of network benefits for the patient.

It’s important to them. They want to understand their insurance.

Most of the out-of-network providers can file the benefits for the patient to be seen out of network. The insurance may pay the same fee, but the patient is paying possibly a greater share of the fee, especially if they’re not getting the same reduced fee schedule.

This may happen if they’re not getting the reduced fee schedule or there could be a different percentage paid to out of network providers by the insurance.

Some out-of-network insurance coverage like Medicaid won’t pay a benefit if the patient goes out of network.

So you really need to know if the plan for the patient is a PPO or an EPO and many are PPOs
but some are EPOs and so we need to check the details.

If you’re certain that they’re in-network providers, you can just let the patient know yes and we can file this insurance.

But if you’re not sure if it’s an in-network provider, don’t just send the patient away struggling to find the care they need and not learning anything about their insurance.

Help the patient, help them understand their benefits.

Helping patients understand their benefits

Offer to do a benefits check.

Set up the patient in the computer with their contact information and their insurance group
information.

Get the provider relations number for the insurance and then create a system in your office to do these benefit checks.

Maybe you put their name on a clipboard, maybe you keep their names on a list on a spreadsheet.

You could even have an online form that you can enter the patient in and the staff member can track the patients who need a benefits check.

This form could even be made into a portal on your website to offer to do benefits checks for patients.

And then your staff member can look at the collected info to check benefits- always make sure after you do the benefits check that the patient gets a follow-up call and that the information is saved in the practice management software for reference.

What to do for the benefits check first?

First get a summary of benefits for the insurance, maybe on the phone or on the fax or using the online portals for the insurance. You can request a summary of the benefits that you can scan into your practice management software.

Ask the provider relations representative if your office is in network or are there any thirdparty administrators that cover this plan with your office. And note this information for your patient in the notes section of your practice management software. 

In general, it may help to annually update your insurance coverage for local employers in your practice management system so that it’s stored in your computer and after one call is made to the insurance, the information is saved for not just that patient but for other patients as well. Start with new patients or patients who have large treatment plans and questions about insurance benefits.

You can save this information by group number. Using the group number to name the plan will avoid duplicating plan information with multiple names in your software. Always add the date the information was check as part of the name for future reference. Save this benefit plan on file and to be able to link it to new patients when adding their group number to that same plan. And using the group number to name the insurance plan will help you make sure that you don’t duplicate the different plan names.

You don’t want to have to call the insurance multiple times, so try to have a consistent naming system. Having the information in your software helps so that way you can see the coverage for different categories of insurance benefits.

You can also add notes regarding the in-network coverage for your office and if there’s any third-party administrators that link this plan to your in-network providers. You can add information about frequency of services if helpful.

And now you can let the patient know more about the plan.

If it’s an EPO or a state plan like Medicaid, they may have to see an in-network provider.

If it’s an open panel plan, like many PPOs, they may be able to go to an in-network or an outof-network provider and you can let them know if your office is in-network or if you’re an
out-of-network provider for this plan, you can also let the patient know some estimated cost
ranges for a consult. 

If your office is an out-of-network provider, what percentage does their plan pay for exams and preventative care?

Is it a one hundred percent?

Do you have a copy of the plans fee schedule?

Can you offer to share your consultation price for the patient to first try the office?

You can let the patient know these costs for an initial visit- then once we have a detailed treatment plan based on the comprehensive dental exam – we can give a more accurate picture of costs for treatment based on what needs to be done.

You may want to let the patient know. We have lots of patients with your insurance who come here.

We can do a benefits check and follow up to let you know the benefits of your plan and the cost of your initial visit. And once we have a comprehensive treatment plan to take care of your needs, we can do more specific benefits checks based on what you need.

We can do a benefits check and follow up to let you know the cost of your visit. And then if we’re out of network, if the office is an out of network provider and the insurance will pay out of network, let the patient know what’s the cost for the initial cleaning or the initial consult. Have a set fee you can assure the patient for that first visit- and document it for other staff to know. 

Help patients avoid financial surprises

We don’t want patients to have financial surprises, so let the patient know that if you’re an in-network provider, out-of-network provider.

If you aren’t sure if you’re an in-network provider, offer to do a benefits check to get their information and follow up with an estimate for that first new patient visit.

Let them know this is the cost for the first visit, for the consult for the new patient or maybe a cleaning.

And then once we see you at the office, we can make a dental treatment plan to know what actually needs to be done and we can check benefits again after your first visit.

For the dental treatment, we will create the treatment plan and we may have a policy that if the treatment plan’s over a certain dollar amount, we’ll do a benefits check online or we’ll send the information to the insurance to request a pre-estimate for fees and we can get that information for the patient to avoid surprises.

But our goal is to get the patient the care they need and to help them better understand their benefits. We don’t want them to have any financial surprises.

So let’s try to get them the information they need and get them scheduled and get them a plan for care.

10,540 thoughts on “Do you take my insurance?”

  1. Lazrhzx

    [u][b] Привет, друзья![/b][/u]
    [b]Мы изготавливаем дипломы[/b] психологов, юристов, экономистов и любых других профессий по приятным ценам.
    [url=http://cse.google.lu/url?q=aurus-diploms.com/]cse.google.lu/url?q=aurus-diploms.com[/url]

    Reply
  4. BeguZguase

    Косметика CozarSkin создана для тех, кто ценит качество и результат. Благодаря качественным ингредиентам и нашему опыту, у вас кожа будет ухоженная и красивая. Продукция сделана на основе научных исследований. https://cozarskin.ru – сайт, где представлены отзывы покупателей. Здесь узнаете, какой шампунь, а также кондиционер идеально подходят для ваших волос. Наша главная цель – помочь каждому найти свою здоровую кожу и уникальную красоту. Обращайтесь к нам, мы ответственно относимся к любому заказу.

    Reply
  6. Juniornounc

    https://fileforum.com/profile/sharonsphynx3/

    If you’re a fan of Ceylon Cinnamon, you’re in for a treat! I recently stumbled upon an incredible resource that covers everything you need to know about this extraordinary spice. From premium Ceylon Cinnamon powder and sticks to convenient tea bags, this site has a vast selection of top-notch products that cater to all your culinary and wellness needs.

    One of the standout features of this resource is its detailed guide on the health benefits of Ceylon Cinnamon. It’s fascinating to read about how this spice can positively impact blood sugar levels, offer anti-inflammatory benefits, and provide powerful antioxidants. The information is well-researched and practical, helping you understand how to incorporate Ceylon Cinnamon into your daily routine effectively.

    Additionally, the site offers an invaluable buying guide for authentic Ceylon Cinnamon products. If you’ve ever struggled to find high-quality Ceylon Cinnamon or wondered which brands are trustworthy, this guide is a game-changer. It highlights reputable suppliers and retailers, making it easier to get your hands on the genuine article, whether you prefer shopping online or in-store.

    For those who enjoy experimenting in the kitchen or simply want to add a touch of flavor to their meals, the variety of products available—like the aromatic sticks and versatile powder—is impressive. And if you’re a tea lover, the selection of Ceylon Cinnamon tea bags might just become your new favorite go-to.

    Overall, if you’re interested in exploring the world of Ceylon Cinnamon, this resource is a must-visit. It provides everything from product recommendations to health insights, making it a valuable tool for both new and seasoned enthusiasts.

    Reply
  7. Larryprisa

    Приватные читы Arena Breakout поспособствуют вашему
    доминированию в Темной зоне. Теперь вам будет проще соперничать
    даже с самыми сильными соперниками, одерживая победу и получая
    превосходство в каждом сражении.

    arena breakout читы

    Reply
  8. Fevakah

    [url=https://prepaid-cards.cvv2cvc.net]https://prepaid-cards.cvv2cvc.net[/url]

    Item 1 Card Total Balance: $3100 – Price $ 110.00
    Item 3 Cards Total Balance $9600 – Price $ 180.00
    Item PayPal Transfers $500 – Price $ 49.00
    Item PayPal Transfers $2 000 – Price $ 149.00
    Item Western Union Transfers $ 1000 – Price $ 99.00
    Item Western Union Transfers $ 300 – Price $ 249.00

    *Prices on the website may vary slightly

    [url=https://prepaid-cards.cvv2cvc.net]https://prepaid-cards.cvv2cvc.net[/url]

    Reply
  9. Williamfes

    Ремонт бытовой техники и электроники в Москве. Своевременный ремонт бытового оборудования – это гарантия его долгой и исправной работы [url=http://spb-remont-iphone.ru]сервисный центр по ремонту мобильных телефонов[/url]

    Reply
  13. celpKext

    The casino was my downfall. I, Alex, squandered it all at the slot machines.
    Constantly, the roulette wheel spun its hypnotic dance. The whir of slot machines was my siren’s call.
    My wife, Lisa, implored me to leave the poker tables, but the lure of the jackpot was too strong.
    On that disastrous night at the underground gambling den, I gambled everything: our security, our residence – on a “sure thing” bet.
    The dice rolled snake eyes and fortune abandoned me.
    Returning to our apartment with not a penny to my name, I found only a note: “I’m leaving. Your obsession with poker has destroyed us.”
    Alone in an hollow home, I understood that seeking the perfect bet stripped me of my true treasures.
    Health experts recognized clinical depression, intensified by my yearning for the casino floor.
    Now, constantly is a battle not just with my urge to return to the casino, but with the deep darkness that haunts me. Do I have the strength to rise above this pit left by my addiction to betting?
    >>>
    aristocrat online slots free

    Reply
  17. Williamfes

    Ремонт бытовой техники и электроники в Москве. Своевременный ремонт бытового оборудования – это гарантия его долгой и исправной работы [url=http://spb-remont-iphone.ru]сервисный центр ремонт техники москва[/url]

    Reply
  18. Juniornounc

    https://chart-studio.plotly.com/~landbeef7

    If you’re a fan of Ceylon Cinnamon, you’re in for a treat! I recently stumbled upon an incredible resource that covers everything you need to know about this extraordinary spice. From premium Ceylon Cinnamon powder and sticks to convenient tea bags, this site has a vast selection of top-notch products that cater to all your culinary and wellness needs.

    One of the standout features of this resource is its detailed guide on the health benefits of Ceylon Cinnamon. It’s fascinating to read about how this spice can positively impact blood sugar levels, offer anti-inflammatory benefits, and provide powerful antioxidants. The information is well-researched and practical, helping you understand how to incorporate Ceylon Cinnamon into your daily routine effectively.

    Additionally, the site offers an invaluable buying guide for authentic Ceylon Cinnamon products. If you’ve ever struggled to find high-quality Ceylon Cinnamon or wondered which brands are trustworthy, this guide is a game-changer. It highlights reputable suppliers and retailers, making it easier to get your hands on the genuine article, whether you prefer shopping online or in-store.

    For those who enjoy experimenting in the kitchen or simply want to add a touch of flavor to their meals, the variety of products available—like the aromatic sticks and versatile powder—is impressive. And if you’re a tea lover, the selection of Ceylon Cinnamon tea bags might just become your new favorite go-to.

    Overall, if you’re interested in exploring the world of Ceylon Cinnamon, this resource is a must-visit. It provides everything from product recommendations to health insights, making it a valuable tool for both new and seasoned enthusiasts.

    Reply
  19. GrigZoDal

    Компания Mpdkeymuhu предлагает надежные и стабильные тарифы с защитой от ddos-атак, гарантией возврата за неиспользованный период антивирусной проверкой файлов. Здесь у вас есть возможность подобрать vps и dedicated серверы, а также виртуальный хостинг для проектов различной сложности. Ищете реконструкция деревянного дома стоимость? – это портал, где вам предлагаются услуги регистрации хостинга, доменов и иные решения для защиты и создания сайтов. Заходите на ресурс, здесь вас ждет исключительно занимательная информация, удостоверьтесь в этом сами.

    Reply
  22. Sazrhuf

    [u][b] Здравствуйте![/b][/u]
    Купить документ ВУЗа
    [url=http://newrealgames.ru/poluchite-diplom-o-vyisshem-obrazovanii-bez-lishnih-hlopot/]newrealgames.ru/poluchite-diplom-o-vyisshem-obrazovanii-bez-lishnih-hlopot[/url]
    [url=http://androidinweb.ru/diplomyi-dlya-ambitsioznyih-lyudey/]androidinweb.ru/diplomyi-dlya-ambitsioznyih-lyudey[/url]
    [url=http://little-witch.ru/forum99/]little-witch.ru/forum99[/url]
    [url=http://nsibirsk.ru/forum/obyavleniya/newtopic/#google_vignette/]nsibirsk.ru/forum/obyavleniya/newtopic/#google_vignette[/url]
    [url=http://goruss.ru/blogs/1111/Быстрый-и-надежный-способ-получить-диплом/]goruss.ru/blogs/1111/Быстрый-и-надежный-способ-получить-диплом[/url]

    Reply
  23. canadian pharmaceutical companies

    Have you ever thought about including a little bit more than just your articles? I mean, what you say is fundamental and all. However think of if you added some great images or video clips to give your posts more, “pop”! Your content is excellent but with images and video clips, this website could definitely be one of the most beneficial in its field. Excellent blog!

    Reply
  24. Juniornounc

    https://www.mapleprimes.com/users/tennissilver4

    Hey there, cinnamon lovers! If you’re as obsessed with Ceylon cinnamon toothpicks as I am, you’ve got to check out this incredible resource I found. It’s like a candy shop for anyone who appreciates the magic of these little sticks.

    So, what makes these toothpicks so special? For starters, they’re made from genuine Ceylon cinnamon—none of that common Cassia stuff. The difference is like night and day; Ceylon cinnamon has this sweet, delicate flavor that just elevates your toothpick game. Whether you’re into a subtle cinnamon kiss or a more intense burst of flavor, this site has you covered.

    But here’s the kicker: it’s not just about the products. This place goes all out with tons of info on why Ceylon cinnamon is so awesome. You’ll find all the juicy details on its benefits, like how it helps with oral health and freshens up your breath. Plus, their blog is packed with creative tips on how to use these toothpicks in everyday life—think fancy cocktail garnishes or cool homemade gifts.

    So if you’re curious about Ceylon cinnamon toothpicks or just want to dive deeper into the world of these spicy little wonders, this site is your new best friend. It’s got everything you need, from top-quality products to all the background info you could want. Trust me, it’s worth a visit if you’re ready to up your toothpick game!

    Reply
  25. Juniornounc

    http://latenitetip.com/index.php?page=user&action=pub_profile&id=498921

    Lately, I’ve been trying some Ceylon Cinnamon Recipes because I heard this stuff is the real deal when it comes to cinnamon. I got my hands on some Ceylon Cinnamon Powder, and wow, the difference is huge! The moment I opened the jar, the aroma was incredible—way richer and more complex than the regular cinnamon I usually use.

    I started by swapping out the usual cinnamon in my cinnamon roll recipe with this Ceylon powder. Let me tell you, those rolls were on another level. They had this amazing depth of flavor that made them taste like something you’d get at a fancy bakery. I also tried adding it to my morning oatmeal, and it was like a cozy hug in a bowl. It made my breakfast feel so much more special.

    I didn’t stop there—I also explored some Ceylon Cinnamon Products. I grabbed a few cinnamon sticks and even tried some cinnamon-infused teas. The sticks were perfect for making mulled wine. They added this deep, warming flavor that made my drink feel like a holiday in a glass. And the cinnamon teas? Totally relaxing and perfect for winding down at the end of the day.

    All in all, adding Ceylon cinnamon to my kitchen has been a game-changer. It’s amazing how a little change in spice can make such a big difference in flavor. If you haven’t tried Ceylon cinnamon yet, you definitely should. It’s been a fun and tasty discovery for me, and I can’t wait to keep experimenting with it!

    Reply
  30. Лазертаг

    Лазертаг для подростков lazertag-portal.ru

    По поводу [url=https://spb.lazertag-portal.ru/]лазертаг для детей[/url] мы Вам непременно поможем. Лазертаг можно считать как просто развлекательную игра, а можно как вид спорта. Именно поэтому детки так любят эти поразительные поединки, динамичность, внимание и новые чувства Вам будут обеспечены. Празднование дня рождения в арене «Портал» – это что-то другое и оригинальное, дети скажут Вам спасибо.

    Reply
  35. Лазертаг

    Сколько стоит день рождения в лазертаг lazertag-portal.ru

    По поводу [url=https://spb.lazertag-portal.ru/]лазерный лазертаг[/url] мы Вам непременно поможем. Лазертаг можно воспринимать как просто увлекательную игра, а можно как спорт. Непосредственно, поэтому дети так любят эти ошеломительные поединки, динамичность, внимание и супер чувства Вам будут предоставлены. Отмечание дня рождения в арене «Портал» – это что-то другое и небанальное, дети будут Вам благодарны.

    Reply
  39. Лазертаг

    Детский лазертаг lazertag-portal.ru

    По вопросу [url=https://ekaterinburg.lazertag-portal.ru/]лазертаг площадка[/url] мы Вам непременно окажем помощь. Лазертаг можно воспринимать как только интересную игра, а возможно как спорт. Непосредственно, поэтому дети так любят эти поразительные бои, активность, интерес и супер эмоции Вам будут предоставлены. Отмечание дня рождения в арене «Портал» – это что-то иное и небанальное, дети будут Вам благодарны.

    Reply
  41. Ronaldvax

    Кольпоскопия Плюс — специализированный сайт клиники «Гинеколог Плюс» в Пятигорске, посвященный кольпоскопии. Мы предлагаем высокоточные исследования для раннего выявления заболеваний шейки матки. Опытные специалисты, современное оборудование и индивидуальный подход — всё для вашего здоровья и спокойствия [url=https://xn—–6kchhabn0adteizrbepgqvr6hyj.xn--p1ai/zapis-na-priem/]Записаться на приём[/url]

    Reply
  42. Andrewmap

    לך. הן מציעות לך בילוי חושני ומשחרר. אתה יכול להגיע אליהן בכל ימות השבוע ובכל שעות היממה. וההנאה תמיד מובטחת. אתה יכול לעשות במהרה לפורקן עוצמתי שבא לידי ביטוי בהתכווצויות משחררות בגוף. נשים וגברים חווים זאת אחרת, אבל כולם מגיעים לאותה הנקודה של רוגע נערות ליווי בנצרת עילית

    Reply
  44. StevenExile

    Наша клиника использует современные методы лечения бесплодия и минимально инвазивные технологии, такие как лапароскопическая хирургия, что позволяет сократить время восстановления и снизить риски. В Гинеколог Плюс вы получите экспертную помощь в гинекологии от ведущих специалистов, которые применяют современные методы лечения и предлагают индивидуальный подход к каждой пациентк [url=https://xn—–elccadjfufrggzrbgpwuq9z.xn--p1ai/vvedenie-v-laparoskopiyu-chto-eto-takoe/]Введение в лапароскопию: что это такое[/url]

    Reply
  45. Uazrmbx

    [u][b]Здравствуйте![/b][/u]
    [b]Приобрести диплом о высшем образовании.[/b]
    [url=http://telegra.ph/kupit-diplom-kaluga-08-13-2/]telegra.ph/kupit-diplom-kaluga-08-13-2[/url]

    Reply
  47. Alislvam

    Вы заинтересовались перевозками негабаритных грузов? Позвоните нам! Мы гарантируем выгодные цены. К каждому заказу подходим индивидуально. Используем современное оборудование, соблюдаем нужные стандарты безопасности, чтобы обеспечить надежную и своевременную доставку вашего груза. Можете довериться нам на все 100%. Ищете такелаж трансформаторов под ключ? Negabaritnyj-msk.ru – портал, где можно найти еще больше о нашей компании информации. Находимся в вашем распоряжении 24/7. Свяжитесь с нами, если появятся интересующие вас вопросы. Всегда готовы вам помочь!

    Reply
  50. Andrewmap

    דיסקרטיות באשקלון הן המקום בו חלומות מתגשמים. זוהי לא סתם קלישאה, יש שם נערות מושלמות שיודעות את הדרכים המסתוריות שבהן אפשר עם נערת החלומות. מאמר 4 דירות דיסקרטיות בבאר שבע לבילוי בלתי נשכח בדרום לא סתם אומרים שחם בבאר שבע! דירות דיסקרטיות בבאר sharp

    Reply

Leave a Comment

Your email address will not be published. Required fields are marked *