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Dental Insurance Participation Considerations Post-COVID

COVID-19 is leading dentists to review every part of their business plan and that includes their relationship with dental insurance networks.

Teresa Duncan is a nationally known dental insurance expert, speaker, and author. She wrote the book “Moving Your Patients to Yes: Easy Insurance Conversations,” hosts the podcast “Nobody Told Me That,” and speaks at dental conferences all around the country. Since the COVID-19 pandemic began, she’s been in constant contact with dental insurance carriers and with providers and shared her insights with Patient Prism CEO Amol Nirgudkar in this video.

Fee for Services vs. In-Network with Dental Insurance Carriers

Many dentists who are in-network with dental insurance carriers are faring better during the coronavirus shutdown because they have revenue coming in from insurance accounts receivable.

“I’ve been on a lot of calls with doctors, and when they took a look at their numbers, it was startling to see that 80% of their money in March was coming from carriers,” said Teresa Duncan.

“Now the landscape has changed, and millions of people have lost their jobs and benefits. It’s unclear whether patients without insurance will want to go to the dentist because they may be afraid of the cost,” she continued  “In every case, it’s important for the dental practice to have affordable payment options to offer to their patients so they can get the treatment they need.”

Ensure Insurance Carriers Have Correct Contact Information for You

These are unprecedented times, and a lot of dental team members have been furloughed or temporarily laid off.

It’s important to make sure your dental insurance carriers know how to reach somebody at your practice. Now is a good time to review your contracts and confirm that the contact information for your practice is still accurate.

Most dental insurance carriers are sending information electronically, so check email – including your spam folder - daily.

Online Tools for Faster Claim Processing and Payment

Many dental insurance companies are urging dentists to take advantage of electronic and online tools available to submit dental claims for faster processing and payment.

Dental benefits carriers also allow practices to check patient information such as treatment history, eligibility and benefits information through automated phone systems or online portals.

How COVID-19 Impacts Dental Premiums & Policies

“I know for a fact that some employers are asking for their dental premiums back because people aren’t going to the dentist,” said Teresa Duncan.

Dental insurance carriers are weighing a lot of options including waiving the frequency limitations on certain procedures, stretching out the maximums paid, and creating better fee schedules.

For dentists, this might be a good time to renegotiate your fee schedule.

Delta Dental Foundation Grants

The Delta Dental Foundation announced on March 30, 2020 that it was creating a $500,000 COVID-19 emergency assistance fund to provide a safety-net for dental clinics and non-profits in some states.

The grants were up to $10,000 and are designed for dental clinics that treat the underserved, uninsured and Medicaid populations, which are the demographics most likely to use the hospital emergency room if they have a dental emergency, according to a press release from the Delta Dental Foundation.

They do not need to be paid back.

Dental Insurance Carrier Loans

Some states are offering an advance on future claims payments. Teresa Duncan explained it this way:

The percentage varies from carrier to carrier but have ranged from 1-5% of historic claim amounts. Sandy Pardue of Classic Practice Resources advises opening a separate account for these dollars for easier tracking. This is an option as all providers may not need to take advantage of the programs. Amounts will be deducted from future claim payments until the loan is paid back.

These amounts will need to be tracked for reconciliation with the original loan amount. A good insurance coordinator will need to stay on top of this using debits and credits. Patient communication will be important as well as you’ll likely be applying a ‘Delta advance’ adjustment (for example) to their account.

Additional Resources

Moving Your Patients - Duncan bookTeresa Duncan’s website is Odysseymgmt.com.  It contains a lot of great information including links to her podcast “Nobody Told Me That” and to her book “Moving Your Patients to Yes: Easy Insurance Conversations.”

In addition, she has recorded dozens of insurance tip videos for Patient Prism Academy, including what team members should say about insurance during every part of the patient experience, from the new patient phone call through treatment planning and collections.

For more interviews with experts, training resources, and guides, visit Academy.PatientPrism.com.

There will be a huge need for dentistry once people can resume normal activities. More people than ever will have questions about safety, affordable treatment options, and what’s covered by their insurance plans post-COVID. Visit PatientPrism.com/Overview to find out how we can help your team convert more callers into booked appointments.

About this Industry Leader:

Teresa Duncan, M.S. - Profile Pic

Teresa Duncan, M.S.

Dental Insurance Expert

Teresa is founder of Odyssey Management, author of Moving Your Patients to Yes: Easy Insurance Conversations, and a contributing author to the ADA's CDT 2017 Companion Guide. Teresa is a frequent contributor to The Observer, The Progressive Dentist, and Dr. Bicuspid publications. She served as a founding Trustee for the auxiliary-learning focused DALE Foundation. Teresa is a member of the Academy of Dental Management Consultants and the National Speakers Association. She has been named one of the Top 25 Women in Dentistry by Dental Products Report Magazine and is recognized as a Leader in Consulting by Dentistry Today. Most recently she provided consulting assistance in the development of the American Dental Association's Guidelines for Practice Success™. Teresa received her master's degree in Healthcare Management from Marymount University.

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