We love having the opportunity to come into your office and talk to your entire team. Why? Because when we’re on the “front lines”, we get to hear about the BIG issues and answer your questions! Whether you’re a doctor, a front desk member, a hygienist or a marketer, you can tell us what you’re struggling with on a daily basis… And we can use that information to zero in on your needs!

That’s why we are starting a new series… One that’s specifically tailored to the big issues you wrestle with every single day.

Up first, we’ve got the Mac Daddy of dental practice dilemmas… The one thing that we see teams struggle with time and time again.


We want to help you learn to handle questions about insurance in an effective way, and MOST IMPORTANTLY, we want to help you better serve the patient. So, let’s start out with a few simple questions…

How many patients per day ask you something about insurance? ….. Practically all of them, right?

Ok, better question: How many of those patients have any idea what they’re talking about? ……Practically NONE of them!

The truth is, most of your patients understand very little about their given insurance plan. So how the heck are you supposed to handle these questions?


We’d like to level with you. We’ve heard the murmurs. Let’s talk about what you’re all secretly thinking. You think that we’re telling you to LIE to patients when they ask about insurance. That we’re telling you to TRICK them.

Listen up. That’s the last thing we want– seriously! Repeat after me: I will NEVER lie to a patient. Never, ever, ever.

So… When can you lie to a patient? Never.

The fact is, patients have trained you that it’s YOUR responsibility to know the detailed ins and outs of their insurance plan… But it’s simply not. They’ve trained you by not doing their research. So, what… YOU are supposed to know Every Single Detail of their individual insurance plan? How does that make any sense?

A patient’s insurance is between them and their insurance company. Period. However, you have to respond to their questions. So, consider this…

1) Are you already doing complimentary benefits checks for your patients? Of course!! However, this is a COURTESY to the patient… It shouldn’t be an expectation. You need to frame this in a special, specific way.

2) Doctors– would you choose to tell a patient what they need based on a) an exam/evaluation OR b) based on what their insurance covers? You tell them what they need based on.. well… what they actually NEED, right? So does it seem logical to base an answer to a medically-related issue on something like insurance??

So far, we’ve tried to break into this monster topic one little chunk at a time… This is how I would “sum up” what we’ve reviewed so far. In an ideal world with a lot more time, this is the message that you’d attempt to convey to your patients when they ask about insurance…

We ask that you realize we do not work for an insurance company. Rather, we work 100% for our patients. We believe that insurance can be a great benefit for some of our patients, and we will do everything in our power to make sure you receive maximum benefits allotted in your particular insurance plan. However, the services we provide and the fees which we charge will always be based upon your individual needs, and not on your insurance coverage.

Phew! That’s a mouthful… Since we DON’T live in an ideal world and you probably don’t have time to say that spiel to every single one of your patients, let’s go over some specific responses to different questions you might be asked…


IF the patient doesn’t ask about insurance…..

DON’T bring it up!!!


If they ask “Do you accept insurance?” and they haven’t said anything about “in-network, out of network, HMO,” etc…

DON’T confuse them and give them homework. Say “We work with all insurance companies and we will be happy to do a complimentary benefits check for you when you come in to see us.” This is 100% accurate, honest, and effective.


“Do you take Humana?” And you don’t…. (The answer isn’t “Sure, yeah! Come on in!”)

The answer is: “We work closely with Humana, and we’ll be happy to do a benefits check for you to see what your benefits will cover.”


Now what if they ask very specific questions.

“Do you accept my Aetna PPO?”

Or “Are you in-network with Humana?” (And you aren’t?)

One thing to keep in mind is that the difference between in-network and out of network office is minimal at best. Many patients end up coming back to you ANYWAYS after they go to an in-network office that lacks the same level of personal care! For that reason, we want to avoid closing the door on a patient.

You can respond by saying: “Actually, we are considered out-of-network with that particular plan, and we have many patients with that plan who choose to come see us because of the excellent care and service we provide.”


Okay… Now Medicaid seems like it would be a difficult subject, but I’ve got good news! It’s actually just as straightforward as the others.

“Does your office accept Medicaid?”

Well , if you do—the answer is simple. “Absolutely! We will be happy to accept your Medicaid and can do a complimentary benefits check for you when you come in to see us.”

But what if you DON’T accept Medicaid?

Let me ask you this… Do you have patients in your office that have Medicaid and choose to come see you anyways? Sure! So that’s exactly what you tell the person on the phone. The truth.

“Our Medicaid patients choose one of our convenient payment options.” Many patients are capable of paying out of pocket even though they’re on Medicaid.

However, if you are in one of the few states that doesn’t allow patients to pay cash if they are on Medicaid, and your office doesn’t accept Medicaid, simply say:

“We actually cannot accept Medicaid patients in our office, but here are a few in the area who do: ______, _____, ______. If anything changes in the future, we would love to be your caretaker!”

Make sure to give them a list of providers that accept Medicaid. Turning away a patient is the worst case scenario, but every once in a while, you just don’t have another option.


Well, what do you think? We hope that we were able to clear up some of the big-bad-mystery that’s associated with insurance questions. Our team would love to spend some time with you one-on-one if you’d like to practice the above scenarios… Or answer any specific questions you might have for us! Just call 866-917-2808! And if you haven’t had a chance to try out our On-Site Telephone Trainings, make sure you ask someone on our team for more information!!


Have a productive week!

-Your Scheduling Institute Training Team