Dental office managers: 10 tips to make your life easier

Spend less time sending preauthorizations, and don’t lose same-day production

In my experience, preauthorizations/determinations can be a waste of time. A dental preauthorization is not a guarantee of benefits. Companies often have disclaimers. One from Delta Dental states that “this piece of paper does not guarantee payment from the insurance company.” My recommendation is to look at past insurance statements from a few of your current patients.

Remove all identifying information and put it on one sheet to show the patient why a predetermination may not be necessary. This only prolongs the treatment plan, takes away the sense of urgency that’s been established, and gives the impression that the insurance company knows best. In most cases, predeterminations are useless. Most importantly, coverage books or payment tables provide the information you need to make an informed decision about your patient’s out-of-pocket cost.

Use better words to discuss financials to get better results

I’ve eliminated the words “copayment,” “out-of-pocket,” and “your portion” because they give the impression this is all the patient owes. No one knows for sure what the patient owes until after the claim is received and processed. Replace the weak words with “estimated patient portion,” “your estimated investment,” or “best-guess estimate based on what your insurance has told us about your coverage.”

It’s best to tell the patient the entire amount for the services, what is estimated to be paid by the insurance, their estimated patient portion, and that the insurance company controls their portion. Things may change and they may owe more after the claim is processed. Don’t rely on written disclaimers on the treatment plans—tell the patient! Be clear. Clear communication plus clear expectations equals fewer headaches. 

Decrease patient cancellations

I recommend removing words such as “cancellation” or “reschedule” from your vocabulary. We tend to say, “Let’s go ahead and schedule this appointment for six months and if it doesn’t work out for you, you can call and reschedule.” Instead say, “It’s important that we see you again in October to evaluate the bleeding we saw today on the lower left. Let’s find a day and time when you know for sure you can make it. Our schedule is filling up fast and we want to reserve a time that works best for you.” Notice you mention the when and why the patient needs to come back, not just “in six months.” People will remember better when you use the month and the important reasons for the appointment.

Fill the empty holes in your schedule by saying things differently

Do not start a call with, “Hi Mrs. Jones, this is Brenda from ABC Dental. We had a cancellation in tomorrow’s schedule and I’m calling to see if you want to come in?” A better way to phrase this is, “Hello Mrs. Jones, this is Brenda from ABC Dental. Dr. Smith asked me to give you a call. She noticed that your appointment to fix your cracked tooth isn’t for another two weeks. She’s concerned that waiting could cause more costly or painful dental treatment. She created an opportunity in the schedule for tomorrow at 2 p.m. and wanted to offer it to you.” Don’t lie, and always look in the chart for what was diagnosed, why it’s needed, and what could happen if they don’t proceed with the recommended treatment. Pulling the doctor’s name works well but be sure you tell the doctor. If Mrs. Jones does come in tomorrow, she may discuss the call with the doctor.

Be insurance aware, not insurance driven

Remember, the plan and coverage are decided by the patient’s employer, not by your office. Choose phrases such as, “Your employer’s benefits plan determines how much the insurance will pay toward your services. We do our best to estimate your benefits based on the information your insurance provides. For other people on your plan, this is what the insurance has paid. Insurance can be unpredictable. Would you like me to write the insurance company’s phone number on this treatment plan so you can give them a call with any questions?” Consider giving the patient a copy of your insurance breakdown and tell them this is what you’re basing your information on for the estimate.

Take control of your schedule

Don’t ask when a patient would like to come in, or whether they prefer mornings or afternoons. Instead, offer two appointment days and times that work for that procedure. “Our doctor does this procedure at certain times. Would you prefer Tuesday at 10 a.m. or Wednesday at 3 p.m.?” Don’t worry, if they need something else they’ll tell you. Keep in mind that about half of the people who were planning on scheduling will accept one of those two appointments without question.

Treat your patients the way you want to be treated

Smile, be empathetic, and explain the details. Patients expect you to be the expert. Show them that you’ve earned that title!

 3 bonus tips

Document everything. If it isn’t documented, it didn’t happen.

Submit clean claims by submitting everything for the first time.

Speak highly of each other in front of patients. They hear everything!

Brenda McNulty has 31 years of dental experience and is the owner of DSO Facts, a fractional training officer company. Brenda’s expertise is training and helping the team hold themselves accountable, whether remote or in-office. She creates increased profitability by establishing systems for practices that focus on the talents of each team member. Brenda has spoken at several major dental events. She’s a member of American Association of Dental Office Management, Speaker/Consultant Alliance, Academy of Dental Management Consultants, Dental Entrepreneur Woman, and Women in DSOs.