Helping Patients Understand Their Benefits

Episode #365 with Dayna Johnson

“Sometimes, you have to spell things out in crayon for people.” And this is exactly what today’s guest does best. Kirk Behrendt brings in Dayna Johnson, a Dentrix expert, to share advice for helping patients understand their insurance benefits. It is more difficult than ever to navigate insurance — for both your patients and your team! To be better prepared for your patients’ questions and to become better advocates as a practice, listen to Episode 365 of The Best Practices Show!

Main Takeaways:

It is up to dental practices to help patients understand their plan coverage.

Start with the basics and don't overwhelm patients with details.

It is harder than ever to figure out what the patient owes.

Use verbal skills to communicate to patients’ their out-of-pocket costs.

Make sure your practice management software is up to date.

See the reality of what happens at the front desk.

Quotes:

“There are a lot of things that dental teams have to deal with with their patients, their practice management software. I think about the dental team as the advocate for the patient. They're advocating on the patient’s behalf for dental benefits, and they're advocating for their patients for preventative care. And we’re not just dentists; we’re oral health physicians. We’re in the healthcare industry, and it’s up to our teams to advocate for our patients for good, recommended healthcare, for oral healthcare, and getting that paid by the insurance companies. So, there's a lot that our dental teams are having to navigate themselves through.” (3:39—4:30)

“A lot of times, patients don't even care if it’s covered or not covered, ‘Just explain to me what my out-of-pocket is and how I can afford to pay for it. Because you're recommending it to me, and I know I want it because I trust my doctor. Now, how can you help me afford it and pay for it?’ And that's what I want our offices to do, is to really help advocate for their patient as far as understanding what their benefits are. If something’s not covered, or if something has some kind of limitation on it, then how can our teams give that information to our patients without owning those insurance benefits — because those do belong to the patient.” (5:55—6:35)

“Start with the basics. Sometimes, you have to spell things out in crayon for people. Whenever I'm working with a team and we’re presenting treatment, recommended treatment, and they're discussing it with the patient, it’s easy to try and give the patient too many details, too much information. And then, that just confuses people. I always try and help my teams to start with the basics. Let them know what their out-of-pocket is. So, if we’re presenting a crown and a buildup and we know the buildup is not covered, just give them the total, ‘The total is $2,000. Your expected out-of-pocket is going to be $1,500.’ And then, if the patient says, ‘Well, why is my out-of-pocket so high?’ then, we can start adding layers of details.” (6:51—7:54)

“We really want to try and keep it simple. I always try and present things in a very simple way. That way, it sometimes will eliminate a lot of those questions that we don't really need to get into if we don't have to. If patients are okay with a $1,500 out-of-pocket, then we just talk about, ‘Okay. Well, what are our options to pay for it?’ Now, if they start to ask, ‘Well, why is my out-of-pocket so high?’ then, we can add on a layer of, ‘Well, your insurance company, they don't cover this particular service.’ And then, we can start going into different layers of details as patients ask questions.” (7:56—8:38)

“It is harder than ever [to figure out what the patient owes]. When I was in my own dental practice, it used to be insurance covered 100, 80, 50...