Episode 107: How to Respond to the Dreaded Question “Is this covered by my Insurance?”

Naren: This is the less insurance dependence podcast show with my good friend Gary Tackas and myself Naren Arulrajah.

Gary: We appreciate your listenership, your time, and most of all, we appreciate your intention to reduce insurance dependence in your practice. Our goal is to provide information that will help you successfully reduce insurance dependence and convert your practice into a thriving and profitable dental practice that provides you with personal professional and financial satisfaction.

Gary: Welcome to another episode of the less insurance dependence podcast. I’m Gary Takacs, your co-host and we have a great topic for you today. As you saw in the headline, the topic is how to respond to the dreaded question from your patients, is this covered by my insurance. We’re going to get into that question in detail and share some wonderful responses that will help your patients think differently about their dental insurance from this day forward. Hey before I do that, I just have a comment I want to start with on this episode. Recently I had a chance to talk to a number of our clients who are in the process of going out of network with PPO plans and one of my clients made the comment to me that he really appreciated having a colleague that he could talk with about the journey. Another dentist that is midway like him going through the process of successfully reducing insurance dependence and he said it’s almost like a built-in support system where this dentist could talk to a colleague about the things that they were experiencing in their practice and he just made the comment that he really appreciated the fact that he could speak to someone else that’s a colleague that was experiencing the same things, not only for support and encouragement but also just for perspective. So, I have a request. My request obviously if you’re a listener of the less insurance dependence podcast, you’re interested in reducing your insurance dependence, I bet someone that could maybe be a colleague like that for you, maybe it’s someone you went to dental school with, maybe it’s a dentist that you’ve really connected with in your CE courses, but I invite you to share the less insurance dependence podcast with a colleague, with a friend, plural even because i do think the idea of having others that speak the same language and are on the same journey can be very helpful. So please share this with one of your colleagues and that can help you as well. Anyway, let’s dive into this topic, how to respond to the dreaded question, is this covered by my insurance

Naren: Hello everyone this is Naren your co-host of the less insurance podcast show. Today we are going to be addressing a question that make almost every dentist that I know cringe. The reality is that if the number one way your dental office attracts new patients is by signing on to PPO plans, the number one question they’ll be asked is, is this covered by my insurance? This is going to happen day in and day out and as more than 90 percent of practices in the United States and Canada have some type of insurance, you’re going to hear this every day. Of course, this question gets so frustrating both for the dentist and the team member, sometimes they just accept it, they accept this is the reality. But in today’s episode Gary will share some effective ways to respond to this question. So instead of letting it kind of frustrate you and instead of giving up Gary’s going to talk about how you can respond to the dreaded question, is this covered by my insurance

Gary: Hey Naren, I hear that question from when I’m in offices and listening, I hear that question almost incessantly when doctor is presenting treatment to the patient, especially treatment that’s asymptomatic, that doesn’t hurt or that’s elected, doesn’t necessarily need to be done and I’ve actually heard dentists in an experience of lower emotional intelligence actually sigh when they get asked that question. The patients say doctors just covered by my insurance and I’ll hear the dentist say, they’re so frustrated. They know they can help the patient. They have the clinical skills and they know how it’s going to benefit the patient but the truth is, the only way the patient wants to have it done is if it’s covered by their insurance and if dentists hear this enough, it’s kind of creates a defeatist perspective. It’s like here we go again, you anticipated happening. If something happens enough you pretty much accept it as reality. Well here it comes, here comes, here comes, and what happens sometimes Naren is that dentists quit recommending ideal treatment or elective treatment because while here comes, here comes, I don’t need to bang my head against the wall. I’m not even going to present it.

Naren: Can I share?

Gary: It’s a downward spiral, it’s a downward spiral that doesn’t help the dentist the practice or the patient.

Naren: Yeah, let me share something that our mutual inspiration Doctor Stephen Covey said. He talks about his time quadrant and he talks about urgent and important, right, things that hurt are urgent. Of course, we’re going to do it, right, like the ring phone, the burning house etc. But the benefit comes from working on the important stuff, the elective stuff, the things that you’re doing today to prevent future problems, benefit both for the practice as well as for the patient. What you’re saying is the patient who’s typically on insurance is trained to just deal with the urgent and the doctors also give up, they’re also dealing with the urgent. So, neither the practice is growing nor the patient’s health is growing. So, they all are like stuck in this urgent loop and never working on the importance. So, this I think is, I mean, just reminded me of what you’re saying work on the important stuff, not work on the urgent stuff.

Gary:  The by-product if that happens is the practice evolves into a tooth at a time practice because you think about what are the benefits covered by insurance whether it’s a thousand dollars a year twelve hundred dollars a year or rarely fifteen hundred dollars a year, that’s basically one tooth.

Naren: Right

Gary: And so, doctors start subconsciously evolving the way they diagnosed to basically just the tooth of the year club let’s just treat the most urgent tooth because that’s all the patient’s going to accept because that’s all the insurance is going to pay for and you think about

Naren: Right

Gary: Think about how contrary that is to their training, to their training to be comprehensive, to help people prevent future problems

Naren: Right

Gary: They’re literally just doing the tooth of the year club. Can you imagine if let’s just relate it outside of dentistry and let’s say someone wanted to carpet their house, re-carpet their house but that isn’t something that would be covered by homeowner’s insurance but if there was such a thing as homeowners’ dental insurance, the insurance company would say what, one room at a time. You’d only do one room at a time and how long would it take you to re-carpet your house? Of course, that’s how many rooms you have but that could take years and years and years. Is that what the consumer wants?

Naren: No

Gary: Does the consumer want and it’ll never match, even if you buy it from the same mill if you’re buying the carpet a year apart, you can guarantee where there’s seams that’s never going to match,

Naren: Even the shade, right, one’s going to have a different shade the older one then

Gary: Even if you use the same lab

Naren: Yeah

Gary: When it’s a year apart, it might be a different ceramic, there might be different materials a year later. It’s never going to match; you’re not serving the patient. So i want to share a response that I have taught our clients, my coaching clients to use, and i have to tell you that they have reported back to me, they say Gary I can’t believe how powerful that response has been and i can’t believe how looking into my patients eyes, I see them literally changing how they’re thinking about their dental insurance. So, drum roll please Naren, here it comes, here comes, the patient says, is this covered by my insurance? And let’s say the answer is no. Which is what it’s going to be most of the time. Of course, we’re not going to say no just outright like that. We’re going to say no, but we’re not going to say it like that. We’re going to say it like this. So Naren asked me the question is if you’re a patient doctor is that covered by my insurance?

Naren: Doctor yeah, I would like to do it but is it covered by my insurance?

Gary: Naren, unfortunately your dental insurance doesn’t care about your health. In fact, they ultimately, their ultimate goal is to have you never visit the dentist because Naren if you never visit the dentist, guess what, they never have to pay claims. So, their goal is to have you never visit, they don’t care one bit about your health as you know Naren, I care deeply about your health and my team cares deeply about your health. So, the ultimate answer to that is unfortunately your insurance company doesn’t care about your health and as a result of that they aren’t going to provide any benefits for the care that I’ve recommended. I’d like to switch the conversation here Naren, to why this treatment is beneficial to you. Now let’s pause on the role playing, think about that for just a minute. Let’s break it down for a minute. What did I say? In the beginning unfortunately your dental insurance company doesn’t care about your health? Now let’s pause here. Is that a true statement?

Naren: Yes

Gary: Absolutely, absolutely. In fact, they ultimately hope you never go to the den. Now some of you might be thinking, oh my gosh, that’s absolutely right. Wow, and when you say that to the patient, unfortunately your dental insurance company doesn’t care about your health, ultimately, they hope you never go to the dentist. What’s happening now when it comes to helping the patient understand whose side, we’re on. Whose side am i on, as a dentist in that role? I am on the patient side.

Naren: Exactly now you’re my colleague you’re my you’re my partner.

Gary: Yeah and I’ll tell you what else is likely happening in the patient’s mind. They’re thinking, right, you’re right. I had to fight my auto insurance company because they didn’t want to pay on a little fender bender I got into. They tried to do everything they could. I had to fight my homeowner’s policy when my homeowner’s policy tried to fight. They’re wonderful when it comes to taking your payments, accepting premiums, but as soon as you have to submit a claim, they’re now the enemy with you and that’s what goes on because everybody I know and I know that’s one of those absolutes. Everybody I know has had, tried to have the wool pulled over their eyes by auto insurance, homeowners’ insurance, other kinds of insurance

Naren: Speaking of that Gary just today my mother-in-law, had a leak on a roof and there’s a lot of damage and they wanted to call the insurance company and they said nope. It’s the guy who did the works fault, the rufus fault. So, we won’t cover it.

Gary: Always trying to always trying to get out of honouring their commitment

Naren: But she has paid thousands and thousands maybe even tens of thousands of thousands

Gary: Tens of thousands but I want you doctors I want you to really think about this. It’s a great way to respond to the question. Unfortunately, your dental insurance company doesn’t care about your health. Ultimately, they hope you never go to the dentist. If you never go to the dentist, they never have to pay a thing and now the patient is suddenly making a shift and notice how I finished that role playing, I said I’d like to switch the conversation to a conversation with you about why this treatment would benefit you, would benefit you. Now I’m not saying 100 percent of the patients are going to go, oh okay then let’s do it, but it’s changing the dialogue, it’s changing the context, it’s changing the dialogue and I believe our listeners here at the less insurance dependence podcast, I believe that their patients do understand the doctor and dental team is on their side. They get derailed because they fall back into those patterns of that, this is covered by my insurance but they get derailed and one of the reasons why I wanted to have this conversation and do this episode is that when you go out of network, when I’m not if, not if, when you go out of network, doctors did you hear that subtle optimism in my word selection there, when you go out of network, one of the things that’s going to happen is you’ll have much more patient retention of your existing patients that are in network when you go out of network because they know you’re on their side. They trust you and they know you’re on their side and they don’t want to roll the dice and go to someone else that they may end up not trusting and they don’t want to go through all of the emotional effort to re-establish trust as trust is emotional and they already have it established with you. They don’t want to have to go do that somewhere else. My clients have reported they said, Gary when you first taught me that I had to take pause because it was very different from the way I’ve responded in the past three years, well unfortunately this is one of those uncovered benefits and that is an answer. It’s just not the most effective answer.

Naren: Gary, can I add something real-quick. We both are fans of Doctor Robert Chaldini and the number one thing he teaches as the most powerful influence principle is what he calls commitment consistency which is mindsets. So, the patient is coming with the mindset of, does is it covered by my insurance. Before you can before they are ready to listen, you need to shift that mindset and what you did just then Gary that language you used about saying insurance doesn’t care about your health which taps into a mindset they already have which is insurance doesn’t care about me, it’s home insurance or whatever. So no point trying to convince them anything till you switch that mindset. So, I really think what you’re teaching is it’s so simple but from a psychological perspective, it’s so powerful.

Gary: Naren, years ago, I found a wonderful plaque in one of my clients, one of my clients offices in their room where they present dentistry, in the area, in the office within their practice where they present treatment and financial options and the plaque said this, think about this, this number of years ago, said beware of bargains in parachutes, hand grenades, and dental treatment, and this is a client who you’d have to understand the appropriateness of that plaque because he has a wonderful sense of humour and all of his patients know that he has a sense of humour and it said it was printed on a brass plaque that hung on the wall and it said beware of bargains in parachutes, hand grenades and dental treatment and it was kind of tongue-in-cheek but not really.

Naren: Yeah, you’re setting the mindset you’re just making them realize guys, if it’s cheap, you’re going to be on the watch out

Gary: Think about this Naren, can you imagine, now you’re a marketing genius.

Naren: Yeah

Gary: Marketing savant. Can you imagine a billboard in any major city in North America?

Naren: Yeah

Gary: That says, the cheapest open-heart surgery available, go to can www.cheapopenheartsurgery.com. Imagine that

Naren: Exactly

Gary: Why doesn’t that billboard say that?

Naren: Because nobody will buy it and actually there is an interesting case. My daughter is in an MBA class, I mean she got into an MBA school and one of the classes, one of the professors talked about a case where India launched the cheapest car. It’s a 100 000-rupee car. Nobody bought it because nobody wants to be seen as buying the cheapest car. It flopped.

Gary: Conversion, how much is that in I think US dollars?

Naren: I think in the us dollars you’re looking at two-thousand-dollar car. So, the car was good they really, really, worked on the engineering they spent hundreds of millions but the minute they called it the cheapest car, they don’t want to touch it at that time

Gary: As a car nut, car aficionado, I have a two word answer no thank you. I guess that’s three words, no thanks. So I have, you’re going to see this in the show notes, we’re going to we’re going to provide this for you in the show note. So, I want you to go to the show notes, it’s at lessinsurancedependence.com. Consider a plaque in your office that says something like this. Have an open mind, have an open mind, if your insurance dictates the quality of treatment you expect to receive, please let us know so we may refer you to another dentist. We choose to treat our patients better. Let me, let me read that again. Imagine a brass plaque in your consultation room or somewhere in your office that said something like this. If your insurance dictates the quality of treatment you expect to receive, please let us know, so we may refer you to another dentist. We choose to treat our patients better. Radical

Naren: Yep

Gary: Radical but it’s the truth

Naren: Yeah but I love the other quote, the other one that your client had.

Gary: Hey if you have a sense of humour use the other one, the other one. Beware of bargains in parachutes, hand grenades, and dental treatment. So, if you’re more serious, use the comment about we choose to treat our patients better, if you have more of a sense of humour, consider the other one.

Naren: We’ll put that in a pdf format. So hopefully if anybody wants to even just take it and do something with it, they can we’ll do that in the show notes.

Gary: And maybe it’s something you could share with your team members and the point is that it is sadly nothing short of a war, a battle between your office and the dental insurance company and in between in the middle of the crossfire, are your patients, and that’s what it is. If you think about it as anything less, you’re not thinking about it in a clear-headed way and I think it’s perfectly okay to be so bold as to say unfortunately your dental insurance company doesn’t care one bit about your health. In fact, they hope you never come to the dentist. If they if you never come to the dentist, they never they never have to pay a claim. However, as you know, we care deeply about your health. That’s a conversation doctors I want you to be comfortable having with your patients and our client my clients tell me that Gary I had to had to referred, I had to work on this but once I worked on it and worked on how I could present that to patients it has been received extremely well and patients have said you’re right doc, you’re absolutely right and I do trust you. Many times, the patient would say, tell me why I should have this done? And then it opens up a wonderful conversation about health, instead about insurance.

Naren: So, you said Gary just before I wrap up, you said after that part one, then you talk about the benefits, right, just want to make sure that if somebody else

Gary: You have to have a benefit statement,

Naren: Yeah.

Gary: Yeah and you talk about the benefits and talk about it in in the framework of the patient. Well hey I want to go ahead and put a ribbon on this one. Thanks so much for listening to this episode of the less insurance dependence podcast. Hey as a closing announcement, we have a thriving dentist MBA workshop coming up on the first Friday of December, first Friday of December, and we have very attractive tuition for that. That one will sell out. In that workshop although it’s a live stream it’s done virtually, although it will sell out. We offer the lowest pricing in advance of the workshop. So, go to thrivingdentist.com. Look at the one day thriving dentist MBA workshop. You’ll see some very attractive tuition. In that workshop I cover the ten elements of a thriving practice and one of those elements just one is how to successfully reduce insurance dependence in your practice. Hey thanks again for listening and thanks for sharing this with your colleague’s thanks so much.