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5 How-to Steps to Drop Insurance Plans

I listen to many recorded calls to dental practices (with the appropriate HIPAA announcement that calls are recorded for training and quality assurance). The most common opening question from prospective patients is, “Do you accept the XYZ insurance plan?” If the answer is “No, we are not in network with that plan,” the phone call often ends abruptly. It’s an insurance hang up, in more ways than one.

If you want to get off plans, do the following:

  1. Build up your fee-for-service practice. If you truly want to have a niche practice focused on quality and not be beholden to insurance companies, then you need to create that successful brand before you start culling the herd. Two ways of accomplishing this goal are by offering a strong mix of profitable services and encouraging your uninsured patients to refer their family and friends.
  2. Everyone on the team—front and back—must be comfortable and ready to make the change.
  3. Provide sufficient lead time for the transition. I do not recommend sending a letter to large numbers of patients telling them that you no longer accept their plan. Instead, inform patients verbally and in writing as they come in for appointments that at a time certain in the future, the change will be made. As new patients call, of course, they should also receive this information.
  4. After speaking to patient in person, hand them a letter explaining the change and invite them to ask questions. Keep your responses brief and straightforward.
  5. Use the best verbal skills. When explaining the change or answering questions, in either the front or back, avoid the following words and phrases:
    • “Out of network.” Don’t lead with this phrase. However, if the patient asks you directly if you are out of network, the response should be, “Yes, we do not work with that plan as a participating provider."
    • “Dropped the plan.” Avoid this phrase because some patients may think you are dropping them as patients.
    • “Overhead.” Patients have little or no sympathy regarding your concerns about overhead.

I offer special Zoom sessions specifically for practices that want to drop participation with dental insurance plans. These sessions are efficient and very cost effective. For a free consultation or more information, get in touch.