Step 1 – Create value
Your office needs to increase your new patient numbers and demand for the practice, but in a quality way, not in a discount or insurance driven way. That strategy is difficult to sustain and is a race to the bottom in terms of being able to provide quality dental care. Increasing new patient numbers can be achieved by differentiating and providing a different experience that people want. The office needs to attract ideal patients that can withstand changes in fees and network relationships
My passion is helping teams to hone in on the dental experience and particularly the sensory experience. I teach teams how to implement an array of calming amenities that have been shown to reduce dental anxiety significantly. Dental anxiety is a serious barrier in the industry and most practices aren’t doing nearly enough to address it which creates the perfect opportunity to stand out and do it better. People without anxiety are simply provided a better experience! Having an office that looks and feels different and a team that knows how to be “sensory sensitive” reduces the fight or flight feeling many patients have because of the dental environment and vulnerability of treatment.
An office can create a brand identity with this concept and begin networking in the community to create visibility and credibility, which leads to profitability. This sets the stage for the office being a magnet for those new, ideal patients and demand increases. The office gets “too busy” and waiting lists result. Yay!
Step 2 – Systems
All the systems the patient experiences as they travel through an appointment need to be cleaned up to create the most optimal experience. This includes phone conversations, check in process, seating the patient, consent forms, the actual dental treatment, and the walk out process. There are also behind the scenes systems that a patient experiences indirectly such as recall, collections/billing, insurance claims and processing, scheduling, and referral thank yous, to name a few.
Most practices have some basic systems for all of these functions of the business but they often aren’t considering how the system may be impacting the patients feelings and anxiety levels. All of these details matter, so it’s important that the systems of the office mirror the same calming, relaxing feeling the patient gets from having amenities and a beautiful office to visit.
Step 3 – Education and Preparation
Once the practice has achieved an elevated experience and value that patients can’t get by switching providers and has the demands of a full schedule with ideal patients, then it becomes even more necessary to start educating patients about what insurance is and what it is not. The dental practice can still be insurance friendly and really they should want their patients to feel they are an advocate for the patient with their insurance. The front office team can do the legwork of understanding the patient’s policy and helping the patient achieve the most out of their benefits while also not letting insurance dictate their treatment. The patient starts to make choices about what is best for their oral health versus what their insurance will cover.
Here is where alternate payment options become even more important. If a patient has an insurance policy that isn’t serving them and covering very little based on what they need or what they are paying, a membership plan with the office might be the best option. The more patients that can be moved from insurance to a membership plan before going fee for service, the better because they don’t need to wrestle with any decision when that network relationship changes. Having payment plan options, extended credit options, etc. is also helpful as the practice may be asking patients to pay more out of pocket or pay for services prior to insurance reimbursement.
Educating the team well in advance on what the unified office verbiage will be once completely out of network with insurances is imperative as once that announcement is made to patients, those conversations start happening left and right and with everyone from the front to the back. The team needs to feel confident in encouraging patients not to panic and to stay with the practice. Get the team involved in reading through the letter the practice will be sending to patients before finalizing to see if they suggest any edits. Controlling the narrative and keeping the decision positive is important in how it is perceived by the team and patients. There may be fear on all sides about how the practice will survive this decision so getting ahead of those fears and having a well thought out plan helps everyone relax into the idea.
There are many logistical details to consider from timing, verbiage, and construction/disbursement of the letter to patients all the way to supplies needed (letterhead, brochures, stamps, etc). Often there is a 90 day span from letting insurance know and when the actual drop occurs. Two different letters may need to be developed as some patients may have out of network coverage with the office while others’ policy may not offer OON option, so no coverage. The team should research those policy nuances beforehand so the doctor knows how many patients this impacts.
Timing of the year is also important to consider as open enrollment for individual policies is a narrow window for people. They may wish to modify their policy for the next year or get off their insurance altogether to stay with the practice. Or the patient may wish to see what their out of network coverage will be with the practice. The more the practice can assist with that the better so again, the dental team is the advocate for the patient and they feel more connected to the office than to the insurance policy. I suggest the office take a proactive approach to answering patient questions. It can be helpful to create an FAQ for the team to share with patients as needed.
Considerations such as network contracts for newer associates need to be reviewed as they may have signed up to be in network for a certain span of time before being able to drop. Understanding how the payment process may change is also important as the insurance company may choose to pay the patient directly which may necessitate a change in the practice’s collection process for those patients.
For offices with many network relationships, I recommend dropping those insurances with the fewest patients involved to start. Be aware of roughly how many patients are on each insurance and create a plan for how/when the drops will occur as the practice is building demand. As patient numbers ramp up, take the opportunity to raise fees, let that stabilize, then drop another plan and so on. For offices heavily dependent on insurance, this process will take longer but following these steps will move a practice closer and closer to independence.
Don’t do this alone! I would love to be your trusted advisor for each of these steps. There are too many little quick tips to make this process as painless as possible and to retain as many patients as is possible. Along the way, you’ll move the practice into achieving higher production and collection goals, help more people that have been putting off care, and become known for your exceptional work and the experience your team provides. These are all positive moves to make and ultimately can lead to creating the fee for service practice of your dreams!
