Case Acceptance Destroyer and Sabotage Trait #4 of 5:
Presenting insurance benefits improperly
This is probably the single biggest issue facing good quality practices today and something that Team Members and Doctors have to commit to overcoming.
I say it every single week in one article or another, that it doesn’t matter whether you are fee for service or in every PPO on the planet – what matters is how your patients make decisions about their overall health and your treatment plans.
Often people will say that they get good case acceptance but they are talking about every patient moving forward with “something” (meaning what insurance is paying for). They are not even looking at all the treatment that gets left behind.
Real case acceptance is what percentage of the total overall treatment plan.
To understand the reality of how truly good or bad you are at dealing with insurance you only need to look at two – that’s it, two – very critical metrics and numbers within your practice.
First – your average treatment value in dollars of every single visit in your schedule…that is the tell tale sign of what your patients are saying yes to. The bigger the average visit, the better you are at getting patients to see, accept, commit to and invest in the big picture of their health.
Second – the percentage of your total collections every single month that comes from insurance companies versus the percentage of money that is coming directly from patients. This will be your ultimate sign to how healthy your practice is. Obviously we want as much money from patients as possible and as low of a percentage of compensation from insurance so you are not at the mercy of or dependent on insurance.
Now those two numbers tell us everything about your experience, patient education, ability to sell, influence, move patients forward with their treatment and optimal health over and above insurance (where the money is at – the profit). Your growth and health of your practice is dependent on these numbers.
So there are three big places and ways team members and often doctors sabotage themselves with insurance.
First – bringing it up way too early and way to often. If it ever comes out of any of your team members’ mouths aside from checking benefits and copying their cards – then you are doing something very wrong.
Second – if any part of the treatment discussion or diagnosis is tied to, anchored by or predicated with insurance benefits or contribution of funds remaining or what it will/won’t cover then you are instantly and immediately commoditizing yourself by removing all value of the role dentistry plays in patients’ lives.
Third – and most importantly what today’s huddle is all about is – how insurance is presented…when it comes down to dollars and cents.
There are four ways most people screw this up…
1 – Telling them what insurance will cover before reviewing the total and entire comprehensive treatment plan
2 – Presenting treatment then insurance and stopping without moving on straight to the patient’s responsibility and making it an assumptive structure that of course the patient must take care of it
3 – Doing anything to overemphasize insurance as important and customary instead of a giant get lucky bonus coupon that they should be grateful for as a supplement to what they should otherwise have had to pay
4 – And probably the biggest one even if you get all of these other three right and you do not make any of the other mistakes – it is letting patients get away with using insurance as their excuse to accept treatment less than ideal or not accept treatment at all
You simply can’t do this. You are the authority and the guide, the expert. Rolling over and giving up because the Patients have a misunderstanding and the entirely wrong idea about what insurance is and what it’s role is (and is not) in their relationship with you is your fault and your responsibility.
Every day I hear practices complaining that they are trying to breakthrough the next growth level or they are in need of more new patients or they have inconsistent days in their schedule…
… 9 out of 10 times the real problem is you have boxed yourself into a plateau and a limited capacity based schedule because you are getting such small amounts of treatment accepted at any one time. And don’t think just because you say you are doing quadrant dentistry that you are; those number up above tell the truth – not your perspective.
Whether single tooth, quadrant dentistry, maximizing insurance or anything else – you are limiting your growth potential, your collections per day, your hourly production and patient values all by how you utilize and deal with insurance in your practice and the way your patients make their decisions.
This should be a whole lot of food for thought. Remember it is not just about the person who actually deals with and asks for money who impacts insurance in your practice. Everyone must be on the same page by setting proper protocols and expectations.
You don’t solve the insurance battle by accident. Instead by being proactive and very deliberate with every part of your patient experience and engagement from phone through diagnosis, payment and completion of treatment.
There is more treatment left in their mouths than ever gets done. You can choose to let insurance squander your case acceptance by sabotaging yourself and your patients or you can take control and do something about it.
What will you decide?
