Dental benefits: Use them or lose them

October 16, 2015

Alitta Boechler, AuD, MBA

Article

As we enter the fall season, chances are that you have patients with remaining dental benefits who also require dental care. According to Forbes, only three percent of patients use all of their benefits in a given year. In fact, according to data collected by Sikka Software, patients, on average, use only 10.8 percent of dental benefits in a given year.

So what is stopping patients from maximizing their dental care? A big portion of those who need care and have benefits are not moving forward with the treatment plan because they may be concerned about copay costs. For major restorative procedures, dental insurance may only pay 50 percent¹, leaving the patient on the hook for hundreds or even thousands of dollars.

This article will discuss how to communicate with patients about financial costs as well as benefit coverage, improving patient care and increasing revenue to your practice.

Speak openly about potential costs and benefits

There are many things running through a patient’s mind when discussing treatment options. One crucial question patients may have is, “Can I really afford this procedure?” This happens when the patient is weighing the cost benefit of the procedure in his or her mind. In this moment, you should provide the patient with the information he or she needs to make an informed decision based on his or her circumstance. What is the anticipated outcome of performing the procedure versus the outcome of delaying the treatment? What is the timeline for completing the procedure?

The patient will likely need detailed financial information to make an informed decision. Let them know what the procedure costs and how much of the fee will be their financial responsibility. Empower your patients to make an informed decision, because they may not know the risks of delayed treatment and will deny the procedure based on the price.

Identify barriers to dental care

Next, ask your patients what they think might be preventing them for receiving quality care. This may be a challenging conversation to have with patients, as it requires a level of trust from the patient. They need to feel comfortable explaining financial barriers, transportation concerns or fears regarding the procedure. Make sure this conversation takes place in a private and comfortable setting with a trusted team member to facilitate communication.

Discuss payment and credit options

A patient may have financing options available through your practice or through other options like CareCredit. Let them know the types of payment and financing options available as well as when the payment is due.

Sending remindersMany patients may have left the clinic before a conversation about financing fully took place, or they requested time to make a decision with family members. Make sure you reach out to those patients and communicate with them regarding expiring dental or Heath Saving Account benefits. Emphasize the importance of completing their oral care plan to improve health and decrease the risk of further complications.

Planning for next year

As a dentist, you have insight into the type of care your patients may need to anticipate in the coming year. How much longer will a filling last, or if treatment was delayed, when should it be scheduled next year? Talk about how much patients might need to save for the future, including in their Health Savings Account, and begin to schedule treatments as soon as necessary. To improve preventive care, move patients from a reactive model to one of ritual care, where regular cleanings are the norm.

Conclusion

In the moment of making treatment decisions, patients may base their decisions on financial costs rather than consideration of their oral health. Dentists and office staff need to be prepared to navigate the often difficult conversations about money. Ensure that the providers and support staff are prepared to speak about financial options to cover out-of-pocket costs. Your patients will have elevated quality of dental care, and your clinic will gain additional revenue from both dental insurance and from over-the-counter payments. There may be many reasons that a dental patient is stalling on having a procedure completed, so be prepared to speak to them about their concerns and find solutions to barriers for care.

More information about Sikka Software, as well as national data trends, can be found at https://www.sikkasoft.com/apps-for-healthcare/dental/

References

diGiacomo, R. (2015). Is dental insurance worth the cost? Bankrate. Retrieved from http://www.bankrate.com/finance/insurance/dental-insurance-1.aspx
Investopedia (2012, June 21). Do you need dental coverage? Forbes. Retrieved from http://www.forbes.com/sites/investopedia/2012/06/21/do-you-need-dental-coverage/