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October 2019

Insurance Acceptance vs. Participation:
Do Your Patients Understand the Difference?

There’s a big difference between accepting dental insurance and participating in a dental insurance plan, and it’s a good habit for dental team members to convey that difference to patients when they call to make an appointment.

According to Ginger Fernandez, manager of professional review and practice management for the Michigan Dental Association, complaints to the MDA occur frequently from patients who were told by a practice “yes, we accept all insurances” only to see a sizable out-of-network bill because the practice doesn’t participate with the patient’s dental insurance plan.

Accepting all insurances is not the same as participating in a dental plan, and the miscommunication often leaves patients feeling like a practice has lied to them,” Fernandez explained. “Office managers should be well-versed in the insurance process, but a patient likely is not.”

For example, an office manager stating to a patient that the dental practice accepts someone’s insurance really means the office will bill the insurance as an out-of-network provider because the practice is not on contract with the patient’s insurance company. But to a patient, chances are good he/she doesn’t understand that the dentist will bill them at his/her fee schedule, which typically results in higher fees than fees within a network. The patient is now surprised by an out-of-pocket cost higher than if the dentist was in the network (participates) with the insurance company. To a patient, acceptance and participation are one and the same.

Front office teams need to understand a patient’s naivety regarding insurance matters and take the extra time to communicate the difference between acceptance and participation. Patients call the office because they want to be proactive and ask questions before making an appointment, so this is the opportune time to educate them and make a great first impression.

Advertising

Another area where confusion over insurance acceptance and participation can occur is advertising. While it’s important for dental practices to acquire new patients, it’s important to carefully phrase the wording of your advertising. Fernandez said some marketing consultants may encourage the use of “we accept all insurances” in the advertisement. While that statement may be true, does a patient really understand what that means?

Repercussions

If patients are surprised by out-of-network charges following an appointment it can lead to some negative repercussions. Obviously, the first repercussion is that your new patient is now upset because he/she owes the office more than what was expected. When this happens the damage to a practice can be far reaching, especially if new patients feel they have been deceived when they are hit with an out-of-network bill.

However, the biggest ramification of not being clear with your communication is the loss of patients and referrals. The office is now cast in a negative light with the patient. Do you think this patient is going to recommend the dental practice to a friend? Chances are that’s not going to happen.

Unfortunately, many offices underestimate the power of word of mouth referrals, not to mention the power of online reviews such as Google and Yelp. A brief proactive explanation of insurance at the first patient contact, plus proper wording of advertisements, could eliminate these repercussions.

So, keep your new patients happy with transparency, educate them of the difference between accepting vs. participating with their insurance, and continue to answer their insurance questions. Having a new patient who is happy and educated when joining your practice will pay dividends for years to come.


Save the Date for the 2020 Mission of Mercy

The 2020 MDA Foundation Mission of Mercy program will take place May 28-31 at the Dort Federal Credit Union Event Center in Flint. Be sure to save the date and watch for volunteer information soon.

Since 2013 the Foundation’s Michigan Mission of Mercy program has united hundreds of dentists, dental team members, and other volunteers to provide dental care to disadvantaged individuals — another example of Michigan dentistry’s commitment to access-to-care.

Missions of Mercy are held every two years. Since 2013, the MOM has provided $4,100,000 in dental health care services at no charge, with 4,947 patient visits.

Be a part of next year’s MOM! For more information, the MDA Foundation website.


Need New Patients? Have Your Doctor Update His/Her Profile

What takes just five minutes and can bring new patients to your practice today? Having the doctor(s) in the office complete their ADA Find-a-Dentist Profile!

The Michigan Dental Association Find-a-Dentist search page — which is connected to the ADA member database — receives thousands of visitors per month. Studies show profiles with photos receive more clicks than profiles without a photo. Updating a profile is quick and easy. Just have the doctor complete the following sections:

  • Business Address: Make sure the box “Display Business Address in the online directories” is checked.
  • Insurance.
  • Payment options.
  • Practice hours.
  • Finally — upload your photo or an image of your practice logo.

UPDATE PROFILE >>


Register now for Upcoming CE Course for Front Office Personnel

Don’t miss this great continuing education course coming up fast.

Friday, Nov. 8

C.O.R.E — Guide to Increased Case Acceptance (Hands-On)

The art of increasing treatment acceptance is inspiring your patients to say “yes” to themselves and what they want first, and then naturally deciding to partner with you as a result of that commitment. This course introduces you to the C.O.R.E — Guide to Increased Case Acceptance, which teaches the “soft skills” necessary to deliver a service-based approach to helping your patients say “yes” without you appearing to be a salesperson.

The cost to attend the seminar is $350 for staff and MDA member dentists, and $450 for nonmember dentists.

This course counts toward the Dental Business Professional certification.
Earn six credits in the Customer Service/Communication category. Click here for more information on the MDA Certified Dental Business Professional program.

REGISTER FOR NOV. 8 SEMINAR >>


Employment Law Posters Are Free from the MDA

Michigan and federal law require employers to display various employment posters covering a variety of Michigan and federal laws.

The MDA offers a free Labor Poster Packet containing all the posters you are required to display in your dental office. The posters are updated on a regular basis.

No need to purchase these posters from third-party vendors — you can get them free from the MDA! To request a poster packet, contact the MDA’s Kelly Risley at 517-346-9406 or email.