Effective communication is crucial in a dental practice, both with patients and insurance companies. Misunderstandings can lead to frustration and delays in payment. Here are some key strategies to improve communication and ensure smooth operations.
Communicating with Insurance Companies
How many times have you called the insurance company to track a past due claim only to be told you have to re-submit it? I can hear the silent screams now!
When dealing with insurance claims, one of the most effective tools in communicating with the insurance companies and getting speedy payments isn’t necessarily the content of the claim, but in the details – they are vital. To avoid resubmitting claims, include detailed documentation up front, such as before and after photos of the procedure. You have to be prepared to plead your case while at the same time getting results now. The documentation notes have to mirror what is submitted on a claim form…why the dentistry was done is crucial. This helps expedite the approval and payment process, reducing the need for follow-up calls.
Establishing Financial Guidelines with Patients
Communication with your patients can be equally frustrating if you think they know the financial guidelines of your practice. Two things are key:
Create and Communicate Financial Policies: Have clear, written financial guidelines and make sure they are communicated to all patients. This transparency helps avoid confusion and ensures patients understand their financial responsibilities.
Discuss Treatment Costs Upfront: Always explain treatment recommendations and associated costs before any dental work is done. Tailor your approach based on the situation:
- Emergency Visits: Have the financial coordinator discuss fees and insurance coverage directly in the treatment room for immediate decisions. The doctor and clinical team members must leave the room at this time to allow for privacy. Discussing financial arrangements chairside can allow for proper communication regarding the patient’s monetary responsibility.
- Routine Appointments: For less extensive treatments, handle financial arrangements at the front desk in a private area. Ensure all financial arrangements are made before the patient comes in for the next treatment appointment to avoid negative surprises.
- Extensive Treatments: Schedule a formal consultation with the patient and the financially responsible party. Provide a written treatment plan and cost estimate, and ensure the patient signs off on it. All patients have a right to know what they are agreeing to.
Handling Payments
To prevent issues with patient payments after insurance has paid, clearly explain the payment process:
- Inform patients that if insurance pays less than estimated, they will receive a final statement. Highlight this on their statement to avoid confusion and potential anger. Tell the patient, “If insurance pays less than we estimate, we will send you a final statement and it will be highlighted in orange at the bottom of your statement with the phrase…’We have received final payment from your insurance’.”
- When changing payment policies, communicate clearly and confidently. For example, if your office stops allowing payment plans, explain the new policy and present the payment options (cash, check, or credit card) during the visit. Offer a courtesy statement with a stamp for those who still prefer to send payments by mail, ensuring a follow-up if necessary. Say to them, “Actually, we are so excited, our payment guidelines have changed and we are now prepared to manage your payment in-office today…so…which would you prefer… cash, check or credit card?” If the patient still objects, give him/her a courtesy statement with an envelope, and a stamp and instruct them to send you the estimate in the next five days. Say that you will follow up with a phone call if for any reason a payment is not received. Then, (internal giggle alert here) say to them “If you decide to call in with your payment, you can peel that stamp off the envelope and re-use it. That is our gift to you!”
The Golden Rule Reminder
Effective communication involves treating patients and insurance companies the way you would like to be treated. By providing clear information and setting expectations upfront, you can minimize misunderstandings and improve the overall experience for your patients and team. Remember the Golden Rule: “Do unto others as you would have them do unto you!”
