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Presenting a Dental Insurance Estimate

If you’re like many dentists with a long-running practice, you’ve likely faced this difficult situation: Dismissing a long-time employee who’s been the rock of your office.

Before Estimating the Dental Fee for Treatment

Before having a discussion with your patient, Huff recommends ensuring that the insurance breakdown in your computer is up-to-date as possible. This allows you to feel confident that you have done as much as is humanly possible. 

Step 1: Review the Work to Be Done

“I usually begin by reviewing what the doctor and hygienist have recommended for treatment, making sure that the patient is very clear on the work to be done and the reason for it,” explains Huff. This is done before the financial discussion.

Step 2: Show Patient the Full Cost

The next step is to show them the estimate of the full cost of the treatment, but have the estimated insurance portion and the patient’s out-of-pocket portion covered up.

Step 3: Ask this Question

Huff says the best verbiage she has found is, “Mrs. Jones, regardless of what your insurance will cover, do you still plan to move forward with this work?” 

The response to this question will help you understand if the patient is one that only accepts treatment if that treatment is fully covered. If that is the case, keep in mind that your job could be to help the patient figure out how to have the work done over time on a budget.

Step 4: Review Estimated Insurance and Patient Portion

After asking that question, Huff proceeds to review the estimated amount that the insurance is expected to pay and also what the patient can expect to pay. All the while, Huff uses the word “estimated” frequently.

Step 5: Assure Patient You Are Doing Your Best

She also tells the patient that she has taken the time to look into the insurance and has tried to be as accurate as possible. “This provides a level of understanding that you are doing your best to know and understand their insurance,” says Huff.

Step 6: Have Financial Agreement Review Notice

Then she asks the patient to sign that she has reviewed the treatment and the cost estimate with them. She does this regardless if the patient has agreed to treatment or not.

At the bottom of the financial agreement that Huff uses, there is a statement that says, “Insurance coverage is only an estimation.  Guarantor is responsible for all treatment not covered by insurance.” Huff says you can highlight this statement in front of the patient to make it clear that you are doing your best to reduce any surprises, and if the cost ends up higher, the patient understands you did your best to make it accurate.



About this Industry Leader:

Colleen Huff, FAADOM - Profile Pic

Colleen Huff, FAADOM

Insurance Specialist

Colleen Huff's dental career began as a Customer Service Rep for Metlife Dental in Utica, NY. From there, a move to New Jersey introduced her to the world of dental offices. Colleen has been an independent consultant for numerous dental offices throughout the country. She has helped grow a practice from the ground up, as well as re-organize established practices. She is currently a practice administrator in Buffalo and the founder/president of the Buffalo/WNY Chapter of AADOM- (D.E.N.T.A.L. Study Group). Colleen achieved her fellowship with AADOM in 2015.

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