Cusptips

Do you take my insurance?

16,081 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.

16,081 thoughts on “Do you take my insurance?”

  6. Arthurglind

    Фабрика кашеварных гарнитуров на Санкт-петербурге – это чемодан фундаментальный участник в творении кухонных интерьеров. Я специализируемся сверху исследованию, производстве а также аппарате первоклассных кашеварных гарнитуров, какие соединяют на себя стиль, работоспособность равно долговечность. Наша миссия – обеспечить покупателям личные ответа, основанные не без; учётом их пожеланий а также необходимостей, чтоб любая кухня таким образом уютным и еще удобным местностью для существования и еще творчества https://www.tivokya0kuhnishki.ru/.

    Reply
  7. Arthurglind

    Фабрика кашеварных гарнитуров в Санкт-петербурге – этто чемодан фундаментальный участник в основании кашеварных интерьеров. Наша сестра специализируемся сверху разработке, изготовлении равно установке первоклассных кашеварных гарнитуров, что соединяют в течение себе стиль, работоспособность и долговечность. Наша роль – передать покупателям отдельные решения, разработанные маленький учётом их пожеланий равно необходимостей, чтобы любил шакша поделалась приятным и еще спокойным местом для жизни и творчества http://www.tivokya0kuhnishki.ru/.

    Reply
  8. CharlesSom

    Notion: An Search of Deliberation

    Philosophy is the swot of fundamental questions regarding living, conception, values, grounds, mind, and language. It encourages individuals to come up with critically round zing’s most unfathomable issues, including the attributes of reality and the heart of morality.

    Branches of Philosophy

    1. Metaphysics
    This spin-off examines the universe of reality. It explores questions such as: What is there? What is the character of objects and their properties? Is there a God? Metaphysics delves into concepts like occasion, space, causality, and possibility.

    2. Epistemology
    Epistemology is the burn the midnight oil of acquaintance and belief. It examines the properties of education, how we acquire it, and the limits of what we can know. Questions like: What is justified belief? What distinguishes fact from opinion? are prime to this field.

    3. Ethics
    Ethics focuses on morals and values. It addresses questions yon what is above-board and flawed and what individuals ought to do. Strange proper theories, such as consequentialism and deontology, cater many frameworks for bargain decent decision-making.

    4. Intelligence
    Wisdom is the ponder of hypothesis and argumentation. It involves the division of arguments, including the building of reasoning and the validity of conclusions exhausted from premises. Common sense is leading in philosophy, as it helps explain thoughts and tag fallacies.

    5. Aesthetics
    This ramification [url=https://thephilosopher.net/dostoevskiyfyodor/audio-knigi/]Dostoyevsky Audio books[/url] explores the nature of stunner and artistic expression. It raises questions round ingenuity, bite, and the acknowledgement of beauty, exploring what makes something aesthetically pleasing.

    Philosophy in Everyday Human being

    Philosophy is not virtuous an non-representational discipline; it is strongly entwined with our habitually lives. We enrol in level-headed opinion whenever we point societal norms, reflect on principled dilemmas, or ponder over insulting beliefs. Whether discussing fair play, individual congruence, or the point of sustenance, opinion plays a decisive job in shaping our worldview.

    Conclusion

    Philosophy invites us to engage with the main aspects of our existence. On exploring the branches of metaphysical philosophy, we wiser interpret ourselves and the people for everyone us. It encourages critical point of view, promotes open-mindedness, and fosters a lifelong exploration quest of information and truth.

    Reply
  9. JustinDycle

    Вы попали в самую точку. Мне кажется это очень отличная мысль. Полностью с Вами соглашусь.
    most often, these are common situations when casino regulars did not comply with requirements for bonuses or she were unlucky in [url=https://www.foie-gras-fermier-gers.fr/2019/12/13/cherche-gaveuse/]https://www.foie-gras-fermier-gers.fr/2019/12/13/cherche-gaveuse/[/url] in their games.

    Reply
  12. Clarkspips

    Отечественный этношоп НашаМебель делает отличное предложение широкий прибор кухонь, какие посодействуют создать устроенность (а) также удобство в течение вашем логове http://notahye4kuhnishki.ru/.

    Reply
  14. MichaelElums

    לקטוף את החלומות, נראה שיש לנו את השותפות הטובות ביותר – נערות ליווי בתל אביב! נערות ליווי יום ובכל שעה, והן רק מחכות שגם אתה דיסקרטיות בתל אביב זה פינוק מהסרטים בדירות הדיסקרטיות מגיע ליהנות מהחופש האינסופי ומתחושות הגבריות שאפשר לקבל בבילוי שכזה. אין מכוני ליווי בתל אביב – לרגע פינוק עילאי

    Reply
  15. MichaelElums

    ים – זה הולך להיות הלילה שלך כאשר מתחשק לך לעשות משהו למען עצמך, אתה רק צריך להזמין את אחת הנערות. לפחד. לא סתם אומרים דירות ליווי ממדינות שונות. לכל אחת מראה שונה וייחודי, ולכל אחת גישה משלה לצורך פינוק הגבר. אבל כולן מקפידות על הנערות ידעו איך לגרום websites

    Reply
  16. Michaelrig

    Наша компания «Сайт числом мебели для кухни» забирается формированием равным образом продажей лучшей кухонной мебели. Наш брат делаем отличное предложение широкий ассортимент продукта, яже дает ответ наиболее передовым эталонам также направленностям дизайна http://www.sufebey8kuhnishki.ru/.

    Reply
  17. BrianUnsep

    Свой инет-магазин “Мебель-шмммммммебель” предлагает широченный круг мебели чтобы кухонь. ЯЗЫК нас вы нахлынете шиздец необходимое для тварей уютного (а) также многофункционального внутреннего убранства http://www.tyfapao6kuhnishki.ru/.

    Reply
  20. TravisBix

    Meet Indi. Timeless and chic. If you’re an Olsen lover, these are for you! Crafted from black acetate with smoked lenses, the style is in [url=https://www.studentsforpeace.com.br/web/guest/home/-/blogs/2927016?_33_redirect=https%3A%2F%2Fwww.rental-car.company%2F]https://www.studentsforpeace.com.br/web/guest/home/-/blogs/2927016?_33_redirect=https%3A%2F%2Fwww.rental-car.company%2F[/url]

    Reply
  21. zaimfssd

    С нами вы имеете возможность оформить [url=https://limazaim.ru]займы онлайн в Минске[/url] круглосуточно, без посещения офиса.

    Reply
  22. Michaelrig

    Наша компания «Фотосайт числом мебели для кухни» воспламеняется организацией и продажей качественной кашеварной мебели. Мы делаем отличное предложение широкий гарнитур(а) продукта, который говорит наиболее современным стандартам и направленностям дизайна https://sufebey8kuhnishki.ru.

    Reply
  25. Michaelrig

    Наша юкос «Фотосайт по мебели для кухни» забирается твореньем также перепродажей лучшей кашеварной мебели. Мы предлагаем широкий гарнитур продукта, яже начинает говорить самым прогрессивным эталонам равным образом направленностям дизайна http://www.sufebey8kuhnishki.ru/.

    Reply
  26. TravisBix

    Meet Indi. Timeless and chic. If you’re an Olsen lover, these are for you! Crafted from black acetate with smoked lenses, the style is in [url=https://lekoufa.ru/banner/go?banner_id=4&link=https://www.rental-car.company/]https://lekoufa.ru/banner/go?banner_id=4&link=https://www.rental-car.company/[/url]

    Reply
  27. BrianUnsep

    Наш инет-магазин “Мебель-шмммммммебель” зовет широкий гарнитур(а) мебели для кухонь. ЯЗЫК нас ваша милость найдете все нужное чтобы сотворения приятного да функционального экстерьера https://tyfapao6kuhnishki.ru.

    Reply
  30. JaredPeK

    A Turkish virtual number is a phone number that allows businesses to establish a local presence in Turkey without needing a physical office. It enables seamless communication with Turkish customers, enhancing trust and accessibility [url=https://composion.ru/?p=50885]купить номер Турции[/url]

    Reply
  31. zaimodvm

    Ищете быстрый способ перевести [url=https://dengibyn.ru]деньги на карту[/url]? Мы рекомендуем лучшие условия для быстрого оформления.

    Reply
  32. Juniornounc

    https://www.bookmarkingqueen.win/las-mejores-agencias-de-marketing-digital-en-santiago-chile

    Hola a todos!

    Queria recomendarles un articulo que encontre recientemente sobre las mejores agencias de marketing digital en Chile. Si estan buscando mejorar la presencia online de su negocio o simplemente quieren conocer mas sobre las agencias que estan marcando la pauta en el pais, este post les puede ser muy util.

    Lo que mas me gusto del articulo es que no es solo una lista generica, sino que se toman el tiempo de explicar que hace destacar a cada agencia. Hablan sobre la especializacion de algunas en SEO, redes sociales o campanas de publicidad digital, y como se adaptan a las necesidades de distintos tipos de empresas, desde pymes hasta grandes corporaciones. Ademas, mencionan ejemplos de casos de exito que te permiten entender mejor como trabajan.

    A veces es complicado elegir una agencia cuando hay tantas opciones, pero este blog post te da una buena base para empezar tu busqueda con mas confianza. Tambien me parecio interesante que destacan agencias no solo en Santiago, sino en varias ciudades de Chile, lo cual es ideal si estas buscando apoyo mas cerca de tu zona.

    Si tienes una empresa que necesita mejorar su visibilidad online o estas pensando en invertir en marketing digital, este articulo te puede ahorrar bastante tiempo investigando. Personalmente, me ayudo a identificar algunas agencias que no conocia y que ahora estoy considerando para futuras campanas.

    Si les interesa el tema o estan buscando alguna recomendacion confiable, les sugiero que le den una mirada al blog. Creo que les puede servir para encontrar la opcion ideal para sus necesidades.

    Saludos y exito en sus proyectos!

    Reply
  34. RichardUsems

    Мы предоставляем широкий спектр услуг, включая оценку, коррекцию лечения, “второе” мнение, назначение препаратов и проведение терапии, наблюдение за динамикой вашего состояния [url=https://sovetisite.blogspot.com/2023/10/blog-post_21.html]https://sovetisite.blogspot.com/2023/10/blog-post_21.html[/url]

    Reply
  35. TravisBix

    Meet Indi. Timeless and chic. If you’re an Olsen lover, these are for you! Crafted from black acetate with smoked lenses, the style is in [url=https://mbyc.dk/proxy.php?link=https://rentcars.buzz/]https://mbyc.dk/proxy.php?link=https://rentcars.buzz/[/url]

    Reply
  36. JaredPeK

    A Turkish virtual number is a phone number that allows businesses to establish a local presence in Turkey without needing a physical office. It enables seamless communication with Turkish customers, enhancing trust and accessibility [url=https://moretraveler.com/virtualnye-nomera-turczii-vash-klyuch-k-iskusstvu-obshheniya-bez-granicz/]турецкий номер телефона[/url]

    Reply
  37. Michaelrig

    Наша компания «Фотосайт числом мебели для кухни» увлекается твореньем и реализацией лучшей кашеварной мебели. Автор предлагаем широкий гарнитур продукта, яже говорит самым современным трафаретам равно тенденциям дизайна http://www.sufebey8kuhnishki.ru/.

    Reply
  38. Michaelrig

    Наша компания «Сайт по мебели чтобы кухни» обучается организацией и еще перепродажей лучшей кашеварной мебели. Мы делаем отличное предложение широченный набор продукта, яже парирует наиболее сегодняшним трафаретам а также направленностям дизайна http://sufebey8kuhnishki.ru/.

    Reply
  39. BrianUnsep

    Выше- инет-магазин “Мебель-шмммммммебель” делает отличное предложение широченный ассортимент мебели для кухонь. У нас ваша милость урвете все необходимое для сотворения уютного (а) также функционального внутреннего убранства http://tyfapao6kuhnishki.ru/.

    Reply
  40. BrianUnsep

    Отечественный инет-магазин “Мебель-шмммммммебель” предлагает широченный коллекция мебели чтобы кухонь. У нас вы откопаете шиздец необходимое для существа уютного также многофункционального внутреннего убранства https://www.tyfapao6kuhnishki.ru/.

    Reply
  41. Daviddrutt

    На сайте https://axiont.ru/ закажите цифровизацию бизнеса. Предприятие занимается активным внедрением цифровых решений для того, чтобы сделать ваш бизнес более прогрессивным, работающим, упростить многие технологические процессы. Программа предлагает мощные, работающие и эффективные инструменты для того, чтобы ваш бизнес стал более успешным. При этом все рабочие процессы будут оптимизированы, что позволит сократить расходы, повысить рентабельность. Прямо сейчас ознакомьтесь со всеми имеющимися проектами.

    Reply
  42. IrisElepe

    офигенно!
    Известные своим оздоровительным эффектом, массажные кабинеты и бани Москвы служат ведь не только в развлекательных целях, [url=https://dai-zharu.ru/peterburg/]https://dai-zharu.ru/peterburg/[/url] но и в медицинских.

    Reply
  43. zaimxnfj

    Теперь всё просто и удобно! [url=https://dengibyn.ru]деньги на карту[/url] зачисляются моментально, без ожиданий.

    Reply
  44. Michaelrig

    Наша юкос «Фотосайт по мебели чтобы кухни» воспламеняется созданием а также продажей качественной кухонной мебели. Автор делаем отличное предложение широкий комплект продукции, который отзывается наиболее прогрессивным образцам да тенденциям дизайна http://www.sufebey8kuhnishki.ru.

    Reply
  45. JaredPeK

    A Turkish virtual number is a phone number that allows businesses to establish a local presence in Turkey without needing a physical office. It enables seamless communication with Turkish customers, enhancing trust and accessibility [url=https://vagaro.ru/preimushhestva-ispolzovaniya-virtualnyx-nomerov.html]турецкий виртуальный номер для смс[/url]

    Reply
  46. Arthurglind

    Фотофабрика кашеварных гарнитуров в течение С-петербурге – это чемодан надежный партнер в течение создании кухонных интерьеров. Ты да я специализируемся сверху разработке, изготовлении также установке высококачественных кухонных гарнитуров, каковые сочетают на себе язык, работоспособность да долговечность. Наша послание – предоставить посетителям субъективные заключения, основанные с учётом их пожеланий также надобностей, чтоб всякая шакша влетела уютным также удобным должностью для жизни а также творчества http://www.tivokya0kuhnishki.ru.

    Reply
  49. list of canadian pharmaceuticals online

    I’m really enjoying the theme/design of your site. Do you ever run into any internet browser compatibility problems? A few of my blog audience have complained about my blog not working correctly in Explorer but looks great in Firefox. Do you have any suggestions to help fix this problem?

    Reply
  50. TeresaMip

    in pair states (Oklahoma and Missouri), legislation is also in force. In 2022, revenue from commercial various games at the [url=https://multikionline.org/user/l8tpqfs688]https://multikionline.org/user/l8tpqfs688[/url] amounted to a record $60.46 billion, which is today at 14% more, than in 2021 y and became the second record year in a row as the industry continued to recover from the covid-19 pandemic.

    Reply

Leave a Comment

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