“How Much Will My Insurance Cover?” Answers to the Hardest Question from Patients with Laura Hatch

As a dentist, you face all kinds of questions throughout the week. The same goes for your front-office staff.

However, without a doubt, the most common question we hear in this profession from dental patients is, “How much will my insurance cover?”

To the uninitiated, this might seem like a fairly straightforward question, but if you work in dentistry, you know this isn’t the case.

You know that this common question can be one of the most difficult to answer and that the wrong answer can be a costly mistake.

“I Only Want to Do What My Insurance Covers”

About 90% of the time, when a dental patient asks you how much their insurance covers, they’re going to follow that up by saying they only want the services they don’t have to pay for.

I spoke to Laura Hatch from Front Office Rocks, a dental office manager and experienced consultant in this field.

According to her, it helps to remember that patients don’t know a lot about dental work. They know what they have in their bank account and they know they want to keep it.

Your job is to recognize they’re in the buying cycle (why else would they be asking?) and then ask them questions that will identify how you can best help.

Don’t ask, “What insurance do you have?”

If you do, you’ll reinforce the idea that this is the most important part of the conversation.

It’s not.

What’s most important is the help the dental patient needs.

So, before reviewing what kind of insurance they have, ask them questions like:

  • What brings you to us?
  • What are you hoping our services can do?

Don’t jump right into going through each line of their policy. Focus on finding out what kind of treatment plan they’re going to need first.

4 Points You Must Understand to Achieve the Right Mindset

This new approach will be much easier for you and your staff to take after you’ve gone through a paradigm shift and adopted a new mindset.  Here are four easy steps you can take to do so.

1. Are You Insurance-Savvy or Insurance-Driven?

Understanding insurance is important. But being driven by insurance is a mistake.

How do you know if you’re being insurance-driven?

Do you think about what kind of coverage someone has the moment you notice a new name on the schedule?

Is it the first thing your receptionist asks a new patient when they call?

Before you put a treatment plan together, do you ask your patient what kind of coverage they have?

Your focus should be the patient’s needs.

That’s your job.

You work for them, not the insurance agency.

If you’re thinking about the insurance agency, you’ll start holding back from recommending all the services a dental patient needs and then no one wins.

2. People Don’t Love What We Sell

Look, I’m a proponent of the idea that you must believe that the money spent in your office is some of the best your patients will ever spend.

Unfortunately, that’s not the popular opinion among the public.

That’s fine, though.

As long as you believe in the value you provide and understand that others don’t always see it that way, you’ll have an easier time dealing with difficult dental patients who don’t want to spend the money on the services they absolutely need.

You’ll be able to detach yourself from what they think about your advice and, when you do that, you can give them your honest assessment.

3. You Can’t Serve Everyone

dental coverage

Along the same lines, some dental patients just don’t put a lot of value on the services you provide.

You can warn them that they’re the only thing standing between them and needing dentures and they won’t care. Dentures will be just fine.

It’s important to understand this.

There’s a reason why there are cheap motels and four-star hotels that cost hundreds of dollars a night.

That’s because, for some people, money spent on the latter is money well spent. Other people just want a pillow and a door that locks.

Neither of these people is better. They just have different values.

Obviously, we greatly value dental care.

We know that it’s essential to living a long, happy life.

But others don’t and you need to accept that. There are plenty of other dentists who will serve them for the price they are willing to pay.

Also, if you find that one carrier keeps sending you the most difficult dental patients, consider limiting your participation with them. You may even get to the point where you can cut them off altogether.

Whatever you do, though, don’t be a dentist who enters negotiations. You provide a valuable service. You’ll be better off if you only provide it to people who value it.

4. Confidence Is Everything

When you’re telling your patients how much a service is going to cost them, never say “um.”

You want to display complete and total confidence. Otherwise, you’re inviting them to question your answer.

Don’t make a big deal of the price, either. If you don’t, the majority of the time, your patients won’t, either.

The Worst Four Words You Can Ever Say

Once you have the right mindset in place, you should have a much easier time answering questions from your dental patients and not just the most common of them all.

Still, just because you know what to say doesn’t mean you know how to say it.

That’s why we’re going to spend a minute going over the worst four words you could possibly say to your patient:

“Do you want to…?”

See, after you answer their initial question about what their insurance company will cover, many of your patients may be on the fence about which services they want.

As we already talked about, some just won’t value their dental care as much as they should.

However, when one of your dental patients is legitimately considering their options, that’s an opportunity to step in and leverage your experience to ensure they make the right decision for their health.

But if you begin by saying, “Do you want to…” before naming a service, you haven’t made a recommendation.

You haven’t even made a suggestion.

You’ve asked for their opinion and displayed zero confidence (you might as well have said, “Um, do you want to…”).

If you know what’s best for them and you truly have their best interest in mind, tell them what they need to do. They can still decline, but at least you know you’ve done everything you could to help.

What to Do When Dental Patients Say, “You Should Know This”

At some point in this discussion, difficult dental patients will often voice their frustration that you don’t know everything about their unique insurance plan. They’ll remind you that you’re contracted with their insurance company.

The first thing to remember here is to stay polite. Nothing good will come from being rude, especially when dealing with difficult dental patients.

Instead, as tactfully as possible, explain to them that your number-one priority is seeing to their dental health. While you do everything you can to stay up-to-date on their dental insurance coverage, that constantly changes. It would be impossible for you to review every single plan every year.

Then, suggest that they speak to their HR department. They are the ones who actually chose the dental plan and it’s their responsibility to ensure that employees understand it.

The Most Valuable Room in Your Office

dental insurance

I’ve been working in dentistry now for more than 40 years and, during that time, I’ve become convinced that there is one room that is more important than all others in an office.

In fact, no matter how much equipment you have in other rooms, there is one that is worth more than all of them put together: the consultation room.

I won’t even consider office space if I don’t see that there’s a consultation room included.

That’s how important I believe these rooms are to a successful practice.


Because real discussions – productive discussions – don’t happen at the front desk.

If you tell a patient how much their insurance will cover, there’s a good chance they’ll schedule an appointment with you just because they don’t want to admit they can’t afford it. They don’t want to stand there as you both come up with a payment plan or discuss their recent bankruptcy.

They’ll take the appointment and never show up.

The lobby is no place to talk about money, insurance, or even potential treatments.

Bring them to a private area where they’ll feel comfortable telling you their real concerns, their real reasons for asking about their coverage, and anything else they need you to know about so you can proceed.

Bring Your Entire Team on Board

Remember, this information isn’t just for you.

Anyone in your office who speaks to your dental patients should know about this.

Also, never forget that you’re the one who sets the example. If your staff notices you dodging questions or peppering your conversations with “um,” don’t be surprised when they do the same.

Take this information, practice it, implement it among your staff, and watch as the “hardest” question your team faces becomes the one they look forward to the most.

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