Misconceptions about Dental Insurance

By: Teresa Duncan

One of the big issues that new dentists face is learning the ins and outs of insurance — it’s a lot of paperwork! A lot of dentists find themselves confused fighting a mountain of red tape.

4 Common Dental Insurance Misconceptions

In case this sounds like you, here are four common misconceptions about dental insurance to avoid:

Misconception 1: Delta doesn’t cover out-of-network care

One huge misconception is that Delta will never cover a procedure that isn’t in the network. That may often be the case, but it’s not always true!

There are sometimes out-of-network procedures that Delta will cover. Unless you’re certain it won’t be covered, it’s always worth a try to send the check.

Misconception 2: Pre-treatment estimates are a waste of time

This one is especially important for younger dentists. People with plenty of experience in the field may tell you that pre-treatment estimates aren’t important. And they have a point! With years of experience, you may not need to bother doing the math before giving a patient an estimate. However, there are three ways to get to that level of experience: practice, practice, and practice!

If you don’t feel comfortable with your pre-treatment estimates yet, there’s nothing wrong with taking some time to calculate an estimate and making sure your patient is well-informed. It’s important to realize that this time isn’t a delay — those patients don’t just waltz out the door forever! Be upfront with them and schedule a time to reconnect and discuss the procedure once you’ve done your estimate.

Misconception 3: Patients only do what insurance covers

A lot of dentists assume the absolute worst when it comes to patient pushback, and that’s not a bad strategy. However, even if insurance doesn’t cover a patient’s specific needs, solutions are more common than you think. Of course, the most important thing is communication.

Let the patient know about flexible payment options, paying in installments, or 3rd party financing. Also, a lot of patients may not realize they’re able to use an HSA, FSA, or WSA to finance dental care — and that can add up!

There are options if a patient’s needs aren’t covered by insurance, but sometimes out-of-pocket expenses just can’t be avoided. Again, the most important thing is communication: present it well, be transparent about why the procedure is important, and make sure they’re aware of all their options.

And if a patient tells you up front that they won’t pay for an out-of-pocket procedure, that’s often a blessing in disguise! Knowing a patient’s limits can be extremely valuable, and you won’t have to waste time figuring out what they might be willing to pay for.

Misconception 4: You have to accept virtual credit card payments

In recent years, especially after COVID, a lot of credit card companies have been using virtual credit cards to reduce processing costs. In effect, though, there’s a processing fee which gets incurred by YOU! These companies often make it very difficult to request other forms of payment like an electronic funds transfer (EFT) or paper check, but you do have the option. Even though these processing fees might be very small percentages, they add up — especially when you’re receiving payments of several thousand dollars from carriers!

Insurance can be a really difficult aspect of managing a practice, and dentists can fall into a lot of errors that hold them back. Keep these four big misconceptions in mind, and hopefully, it will become a lot easier to navigate insurance in your practice!

Photo by Andrea Piacquadio

Teresa Duncan

Teresa Duncan

With over 20 years of healthcare experience, Teresa Duncan addresses topics such as Insurance Coding, Office Manager Training, and Patient Conversations. Her memberships include the National Speakers Association and the National Association of Dental Plans. She has been named one of the Top 25 Women in Dentistry and is the author of Moving Your Patients to Yes: Easy Insurance Conversations as well as a contributing author to the ADA’s annual CDT Companion GuideTM. Her podcasts “Nobody Told Me That!” and “Chew On This!” provide regular coding and management updates. Teresa received her Master’s Degree in Healthcare Management.