Cusptips

Do you take my insurance?

16,070 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.

16,070 thoughts on “Do you take my insurance?”

  1. BrianUnsep

    Свой инет-магазин “Мебель-шмммммммебель” предлагает широченный набор мебели для кухонь. У нас ваша милость найдете шиздец необходимое для создания уютного также многофункционального внутреннего убранства https://www.tyfapao6kuhnishki.ru.

    Reply
  2. Robertmap

    Information about the production, sale and use of recreational cannabis in Mississauga, including the the regulations around retail outlet [url=http://school27vkad.ru/bitrix/rk.php?goto=https://markhamgacannabis.store/]http://school27vkad.ru/bitrix/rk.php?goto=https://markhamgacannabis.store/[/url]

    Reply
  4. Earnestplomy

    Виртуальный турецкий номер — удобная и выгодная альтернатива сим-карте страны. Чтобы купить его, не нужно ехать в Турцию и даже предоставлять документы [url=https://sayt-sozdat.ru/zachem-nuzhen-turetskiy-virtualnyy-nomer/]временный турецкий номер[/url]

    Reply
  5. RobVerslink

    Itm-shop.ru предлагает микрорезцы, метчики, сверла, сменные пластины и др. Сотрудничаем с достойными производителями, их товары необходимым стандартам соответствуют. Устанавливаем оптимальные цены. Ищете магазин промышленный инструмент? Itm-shop.ru – сайт, где можно ознакомиться с электронным каталогом. Здесь легко оформить заказ. Доставка рассчитывается менеджером. Детальнее об условиях читайте в соответствующем разделе. Тщательно следим за качеством поставляемой продукции. Позвоните нам, выберем то, что вам необходимо.

    Reply
  7. CharlesSom

    Philosophy: An Inquiry of Sympathy

    Resignation is the haunt of fundamental questions anent living, understanding, values, end, obey, and language. It encourages individuals to come up with critically there soul’s most well-informed issues, including the type of truth and the basis of morality.

    Branches of Logic

    1. Metaphysics
    This subsection examines the nature of reality. It explores questions such as: What is there? What is the nature of objects and their properties? Is there a God? Metaphysics delves into concepts like era, space, causality, and possibility.

    2. Epistemology
    Epistemology is the study of erudition and belief. It examines the essence of consciousness, how we win it, and the limits of what we can know. Questions like: What is justified belief? What distinguishes correctness from opinion? are key to this field.

    3. Ethics
    Ethics focuses on morality and values. It addresses questions about what is correct and wrong and what individuals ought to do. Opposite fair theories, such as consequentialism and deontology, stock up miscellaneous frameworks respecting settlement upstanding decision-making.

    4. Common sense
    Logic is the library of reasoning and argumentation. It involves the judgement of arguments, including the construct of rationalization and the validity of conclusions strained from premises. Logic is essential in ideology, as it helps purify thoughts and associate fallacies.

    5. Aesthetics
    This branch [url=https://thephilosopher.net/nabokovvladimir/tvorchestvo/lolita/]lolita books[/url] explores the nature of attraction and artistic expression. It raises questions round art, taste, and the obligation of beauty, exploring what makes something aesthetically pleasing.

    Point of view in Everyday Existence

    Metaphysical philosophy is not just an non-representational restraint; it is deeply entwined with our habitually lives. We partake in in impractical reasoning whenever we point societal norms, over on right dilemmas, or ponder across personal beliefs. Whether discussing justice, intimate congruence, or the resoluteness of sustenance, sang-froid plays a crucial job in shaping our worldview.

    Conclusion

    Placidity invites us to busy with the underlying aspects of our existence. Nearby exploring the branches of philosophy, we haler dig ourselves and the in the seventh heaven approximately us. It encourages critical point of view, promotes open-mindedness, and fosters a lifelong quest because appreciation and truth.

    Reply
  9. Robertmap

    Information about the production, sale and use of recreational cannabis in Mississauga, including the the regulations around retail outlet [url=http://claudiaundgregor.weissmann.priv.at/guestbook/go.php?url=https://www.mississaugacannabis.store/]http://claudiaundgregor.weissmann.priv.at/guestbook/go.php?url=https://www.mississaugacannabis.store/[/url]

    Reply
  10. RubenHoodo

    One Plant North Oshawa is home to the biggest selection of Cannabis at the best prices in Oshawa. Shop Cannabis, Flower, Edibles, Beverages, Bongs, Grinders [url=https://www.diamondfilms.com/idioma.php?id=1&ref=https://bramptoncannabis.store/]https://www.diamondfilms.com/idioma.php?id=1&ref=https://bramptoncannabis.store/[/url]

    Reply
  13. Michaelrig

    Наша компания «Сайт числом мебели чтобы кухни» воспламеняется созданием и продажей качественной кашеварной мебели. Ты да я делаем отличное предложение широченный ассортимент продукции, яже отвечает самым теперешним стандартам да направленностям дизайна https://sufebey8kuhnishki.ru/.

    Reply
  14. FlBoyatoma

    На сайте https://demo-it.ru/ воспользуйтесь цифровой трансформацией. А для этого необходимо оставить заявку на портале. Прямо сейчас вы сможете заказать демо 1С. Так у вас получится изучить решение перед тем, как осуществить приобретение либо взять в аренду. Также сможете воспользоваться и арендой программы. Это необходимо для того, чтобы протестировать решение перед тем, как сделать окончательный выбор. А еще это отличная возможность хорошо сэкономить. Воспользуйтесь удаленным обслуживанием, что позволит настроить программное обеспечение.

    Reply
  17. RubenHoodo

    One Plant North Oshawa is home to the biggest selection of Cannabis at the best prices in Oshawa. Shop Cannabis, Flower, Edibles, Beverages, Bongs, Grinders [url=https://uyelik.jollyjoker.com.tr/giris-yap?returnUrl=www.bramptoncannabis.store/]https://uyelik.jollyjoker.com.tr/giris-yap?returnUrl=www.bramptoncannabis.store/[/url]

    Reply
  21. Michaelrig

    Наша компания «Сайт числом мебели для кухни» воспламеняется основанием а также продажей качественной кухонной мебели. Я делаем отличное предложение широкий ассортимент продукта, который отвечает самым прогрессивным эталонам и еще направленностям дизайна https://sufebey8kuhnishki.ru.

    Reply
  22. CharlesSom

    Calmness: An Reconnaissance of Thought

    Resignation is the swot of fundamental questions regarding living, knowledge, values, end, obey, and language. It encourages individuals to think critically there soul’s most profound issues, including the mould of truth and the basis of morality.

    Branches of Logic

    1. Metaphysics
    This branch examines the universe of reality. It explores questions such as: What is there? What is the essence of objects and their properties? Is there a God? Metaphysics delves into concepts like time, order, causality, and possibility.

    2. Epistemology
    Epistemology is the mug up of discernment and belief. It examines the nature of education, how we come into possession of it, and the limits of what we can know. Questions like: What is justified belief? What distinguishes correctness from opinion? are central to this field.

    3. Ethics
    Ethics focuses on morality and values. It addresses questions thither what is right and flawed and what individuals ought to do. Different right theories, such as consequentialism and deontology, victual miscellaneous frameworks recompense bargain moral decision-making.

    4. Logic
    Logic is the library of premises and argumentation. It involves the scrutiny of arguments, including the system of reasoning and the validity of conclusions exhausted from premises. Common sense is essential in ideology, as it helps purify thoughts and specify fallacies.

    5. Aesthetics
    This office [url=https://thephilosopher.net/dostoevskiyfyodor/audio-knigi/]Fyodor Dostoyevsky Audio books[/url] explores the character of belle and artistic expression. It raises questions round taste, suggestion, and the gain of knockout, exploring what makes something aesthetically pleasing.

    Philosophy in Circadian Existence

    Metaphysical philosophy is not even-handed an non-representational discipline; it is powerfully entwined with our always lives. We engage in down-to-earth thinking whenever we question societal norms, ruminate on principled dilemmas, or ponder over in person beliefs. Whether discussing law, individual identity, or the resoluteness of life, philosophy plays a critical role in shaping our worldview.

    Conclusion

    Outlook invites us to undertake with the fundamental aspects of our existence. By exploring the branches of metaphysical philosophy, we excel interpret ourselves and the people encircling us. It encourages important thought, promotes open-mindedness, and fosters a lifelong pilgrimage because apprehension and truth.

    Reply
  23. Michaelrig

    Наша юкос «Сайт числом мебели для кухни» забирается учреждением и еще продажей качественной кухонной мебели. Мы делаем отличное предложение широкий состав продукции, яже парирует наиболее прогрессивным шаблонам равным образом направленностям дизайна https://www.sufebey8kuhnishki.ru/.

    Reply
  24. RubenHoodo

    One Plant North Oshawa is home to the biggest selection of Cannabis at the best prices in Oshawa. Shop Cannabis, Flower, Edibles, Beverages, Bongs, Grinders [url=http://www.impa-ufa.ru/bitrix/redirect.php?goto=https://www.bramptoncannabis.store/]http://www.impa-ufa.ru/bitrix/redirect.php?goto=https://www.bramptoncannabis.store/[/url]

    Reply
  26. Earnestplomy

    Виртуальный турецкий номер — удобная и выгодная альтернатива сим-карте страны. Чтобы купить его, не нужно ехать в Турцию и даже предоставлять документы [url=https://siding-rdm.ru/virtualnyj-nomer-telefona-turcii-bystroe-podkljuchenie-i-komfortnye-razgovory/]турецкий номер телефона[/url]

    Reply
  27. zaimbdzv

    Необходимы средства оперативно? Оформите [url=https://limazaim.ru]займ на карту[/url] и зачислите деньги в кратчайшие сроки.

    Reply
  31. Arthurglind

    Фотофабрика кашеварных гарнитуров на Санкт-петербурге – это ваш надежный участник на существе кашеварных интерьеров. Наша сестра работаем сверху исследованию, производстве и установке высококачественных кухонных гарнитуров, которые соединяют на себя стиль, работоспособность а также долговечность. Наша миссия – предоставить покупателям индивидуальные решения, учрежденные с учётом их пожеланий и потребностей, чтоб каждая шакша стала приятным а также удобным местностью чтобы бытию также творчества http://tivokya0kuhnishki.ru.

    Reply
  35. Robertmap

    Information about the production, sale and use of recreational cannabis in Mississauga, including the the regulations around retail outlet [url=http://mededu.cau.ac.kr/micro/paper_ht.asp?num=257&visit=4&pubmed=mississaugacannabis.store/]http://mededu.cau.ac.kr/micro/paper_ht.asp?num=257&visit=4&pubmed=mississaugacannabis.store/[/url]

    Reply
  37. zaimkafs

    Нужен быстрый способ получить [url=https://dengibyn.ru]займ на карту[/url]? Мы подскажем удобные и выгодные варианты.

    Reply
  39. canadian pharmacy cialis 20mg

    Thanks on your marvelous posting! I quite enjoyed reading it, you might be a great author. I will be sure to bookmark your blog and will often come back in the foreseeable future. I want to encourage you to continue your great writing, have a nice evening!

    Reply
  40. TashaOdodA

    Ох спасибо)) пригодятся))
    Детали надежно крепятся друг к другу и поэтому не ломаются во [url=https://nmiu.com.ua/]nmiu.com.ua[/url] игровое пространство.

    Reply
  41. CharlesSom

    Philosophy: An Exploration of Deliberation

    Sentiment is the haunt of fundamental questions notwithstanding living, knowledge, values, end, obey, and language. It encourages individuals to come up with critically everywhere soul’s most unfathomable issues, including the type of reality and the footing of morality.

    Branches of Logic

    1. Metaphysics
    This subsection examines the nature of reality. It explores questions such as: What is there? What is the category of objects and their properties? Is there a God? Metaphysics delves into concepts like time, space, causality, and possibility.

    2. Epistemology
    Epistemology is the mug up of erudition and belief. It examines the essence of consciousness, how we acquire it, and the limits of what we can know. Questions like: What is justified belief? What distinguishes genuineness from opinion? are key to this field.

    3. Ethics
    Ethics focuses on standards and values. It addresses questions about what is promising and flawed and what individuals ought to do. Opposite ethical theories, such as consequentialism and deontology, stock up sundry frameworks recompense settlement upstanding decision-making.

    4. Common sense
    Logic is the look at of arguments and argumentation. It involves the analysis of arguments, including the building of reasoning and the validity of conclusions exhausted from premises. Logic is key in epistemology, as it helps clarify thoughts and tag fallacies.

    5. Aesthetics
    This branch [url=https://thephilosopher.net/dostoevskiyfyodor/]Dostoyevsky[/url] explores the character of attraction and artistic expression. It raises questions about taste, flavour, and the acknowledgement of knockout, exploring what makes something aesthetically pleasing.

    Idea in Ordinary Existence

    Metaphysical philosophy is not well-grounded an abstract speciality; it is deeply entwined with our habitually lives. We secure in philosophical thinking whenever we absurd societal norms, reflect on open dilemmas, or over across in person beliefs. Whether discussing fair play, personal congruence, or the resoluteness of person, opinion plays a crucial lines in shaping our worldview.

    Conclusion

    Self-control invites us to busy with the main aspects of our existence. On exploring the branches of metaphysical philosophy, we wiser take cognizance of ourselves and the in the seventh heaven encircling us. It encourages critical thinking, promotes open-mindedness, and fosters a lifelong quest because appreciation and truth.

    Reply
  46. RubenHoodo

    One Plant North Oshawa is home to the biggest selection of Cannabis at the best prices in Oshawa. Shop Cannabis, Flower, Edibles, Beverages, Bongs, Grinders [url=http://blog.cgodard.com/?wptouch_switch=desktop&redirect=https://bramptoncannabis.store/]http://blog.cgodard.com/?wptouch_switch=desktop&redirect=https://bramptoncannabis.store/[/url]

    Reply
  47. Clarkspips

    Отечественный магазин НашаМебель делает отличное предложение широкий сортамент кухонь, которые помогут сделать устроенность равно удобство в вашем фамилии http://www.notahye4kuhnishki.ru/.

    Reply
  48. zaimjrdc

    Хотите удобно оформить [url=https://dengibyn.ru]займы онлайн[/url]? Мы предлагаем разнообразные решения на справедливых условиях.

    Reply
  49. Arthurglind

    Фабрика кухонных гарнитуров в течение Санкт-петербурге – этто чемодан фундаментальный партнер в течение твари кухонных интерьеров. Мы работаем сверху исследованию, фабрике а также установке высококачественных кашеварных гарнитуров, кои соединяют в течение себя язык, функциональность а также долговечность. Наша задача – выделить покупателям субъективные ответа, сформированные вместе с учётом ихний пожеланий и надобностей, чтоб любил шакша замерзла приятным также удобным площадью для жизни а также творчества https://tivokya0kuhnishki.ru.

    Reply

Leave a Comment

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