Insurance-Driven Patients in the Dental Practice

Insurance-driven patients is a phrase that I hear a lot when I’m talking to practices about the challenges that they have with getting patients to accept recommended treatment. I want to focus today on the question: "Why are our patients so insurance-driven?" I sometimes find that patients learn that from the practice. Here's what I mean by that.  When I ask my clients: "How often do you take a full set of x-rays?" Many times the practice will answer by saying it depends on what the patient's insurance allows.If their insurance will pay for it every three years, we take it every three years. If the insurance company allows it every five years, we’ll take it every five. But, what my question really means is: "How often does a patient need to have a full mouth xray?" This is just one example of how we, the dental practice, let the insurance company dictate how often we’re doing something. Another example I hear of often is with sealants – whether they’re covered or whether they’re not. For some of my clients if the patient is 13 and insurance allows it then they do sealants. But, if the patient is 16 then they may not even recommend it.

I recommend that you have a team meeting and talk about what types of services does your practice let insurance dictate how often it is performed? Really take a good honest look at whether you are contributing to teaching your patients to be insurance-driven. Patients pick up on this through verbal skills that you’re using when you’re talking to them, or maybe it’s through the patient hand-off when you’re communicating with another team member. I hear phrases such as: "Can this patient have a full mouth debridement? Will their insurance allow it?" When patients hear us asking these questions to another team member the patient may think well it’s up to my insurance company if I have this treatment. What we really should be doing to help our patients get the best possible treatment is to focus on what they need and not what the insurance coverage will allow. You want your patients to pick up on the message for the little things – the preventive and the diagnostic procedures – that this practice focuses on what we need and not what insurance allows. Then when something bigger comes up - let’s say a restorative procedure and there’s either a waiting period or a frequency limitation, or maybe the insurance just isn’t allowing that procedure - the patient has already been sent a very clear message that we focus on health, and we make recommendations based on what you need not what insurance allows.

I encourage you to make this a topic at your next team meeting. When you can change this behavior in your practice, you’re on the way to training your patients to value what they need and not what insurance will pay for.