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Remote Dental Billing and Patient A/R

Let’s Breakdown The Insurance Breakdown Form: Part 1

The dental insurance breakdown form may be the most crucial piece of information you get for your dental office. But why is it so important and do we REALLY have to get a breakdown for each patient? The short answer is YES and let me tell you why.

There are three reasons this seemingly easy task is so vital to an office’s success:

  • Patient Experience

The patient experience goes hand in hand with how well you are versed in their dental insurance. You are the dental expert. It is up to you and your team to know the ins and outs of their plan. Are you a fee for service practice and this patient has a plan on a very low fee schedule? Does this plan have a 12-month waiting period for crowns? How about downgrades; does this plan downgrade white fillings to amalgam on posterior teeth? These are the questions that will make or break a patient’s experience with your office. Patients do not mind paying their dental bills, what they do mind, is paying their SURPRISE dental bills. Take the surprise out of it and get the most accurate and detailed insurance breakdown the first time you call. While I do believe that insurance is always an estimation and never a guarantee of payment, I also believe that it is our responsibility to give them the most accurate insurance breakdown that we can. Not only will this set your office up for success, but it will relay to the patient that you know what you are doing so they can have complete confidence in your team.

  • Collect 100%

A successful practice collects as close to 100% of their patient portion up front and at time of service. As all my aging professionals know, the longer a balance is overdue or the farther a patient is from their date of service, the harder it is to collect that money. How many times have you gotten a statement in the mail and not paid right away, because you know you have time? I know I am guilty of this at times. Don’t delay in getting your doctor paid for their work. When we get the best insurance breakdown we can, it pays tenfold in our collections, and when the office gets paid, ultimately we get paid. With accurate breakdowns, we are able to then collect that third perio maintenance at the time of service, when we know it will not be covered. We may find out that the deductible applies to preventative, so we collect at their first cleaning appointment. We collect on that occlusal guard that is not a covered benefit for bruxism. When you collect the day the balance is due, it is better for the patient, the office and for you.

  • Your Own Growth and Credibility

Ultimately, I believe that understanding a patient’s insurance plan is a growth opportunity for you. Learn how each plan works. Learn what each clause means. Why was there a denial? It builds credibility and confidence in your future with your current office or with another company in the future. When I first started with no dental knowledge, calling insurance companies and getting breakdowns was one of the greatest tools in the beginning of my career to learn the basics of dental insurance. I took this time to ask a representative any questions I did not understand. Through these conversations, my knowledge and confidence grew immensely. When a patient asked me a question at check-out about their bill or their plan, my confidence shined through. It didn’t catch me off guard anymore. Having a detailed breakdown performed for each patient, gave me the confidence I needed and the knowledge I lacked. Let your confidence shine! Ask questions, dig deeper, for your own growth, credibility and future.

Next I am going to begin to go into detail on what each part of the insurance breakdown form means and why we ask these questions. Stay tuned! Get your notes ready and in the meantime go to my website wwww.bonddentalconsutling.com/to download my free detailed insurance breakdown form to follow along.

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