1. Educate Your Dental Team on Talking to Patients About Insurance

Well-trained staff can confidently discuss insurance with patients, directly improving patient satisfaction and retention rates. Proper training also reduces errors in claims submission and billing, saving your practice time and money.

Make sure your team can clearly explain the different types of dental insurance plans to patients:

• Dental PPO (DPPO): Offers flexibility with a network of dentists while typically having higher costs

• Dental HMO (DHMO): Features contracted dentists providing services at set rates with generally lower costs but less flexibility

• Dental Indemnity Plans: Patients pay upfront and submit claims for reimbursement

• Discount Dental/Savings Plans: Not insurance, but it provides discounted rates at participating dentists, including in-house dental plans offered directly by practices

Your team should also be able to explain how insurance typically covers various treatments:

• Preventive care (cleanings, exams, x-rays) is often covered 100% with no deductible

• Basic procedures (fillings, extractions) usually require deductibles and coinsurance

• Major services (crowns, bridges) generally have higher coinsurance percentages and may include waiting periods

• Orthodontics often requires an additional payments and may have lifetime maximum benefits

Ensure your staff understands and can clearly explain these common insurance terms:

• Premium: Monthly cost of the insurance plan

• Deductible: Amount patients pay before insurance coverage begins

• Coinsurance: Percentage of costs patients pay after meeting their deductible

• Annual Maximum: Yearly limit on insurance benefits

• Waiting Period: Time before certain services are covered

Invest in ongoing education for your team through formal courses, webinars, or in-office training sessions. Regular training keeps your team updated on industry changes and new codes, improves insurance verification, and enhances their ability to explain benefits to patients.

2. Initiate Conversations Early When Talking to Dental Patients About Insurance

Discussing insurance information at the beginning of the patient journey sets proper expectations and helps avoid potential misunderstandings later.

Initiate insurance conversations during these key moments:

• During the initial phone call or appointment scheduling

• As part of your new patient intake process

• At check-in for the first appointment

• Always before providing any services

By addressing insurance details during these early touchpoints, you give patients time to understand their financial responsibilities and allow your practice to verify coverage before delivering care.

Taking the time to verify insurance 1-3 days before an appointment can prevent significant headaches. During verification, your team should:

• Confirm the policy is active and covers planned services

• Verify the patient's financial responsibilities (copays, deductibles)

• Identify any prior authorization requirements

• Document all verified information in the patient's file

This proactive approach helps prevent claim denials and billing issues while giving you time to resolve any insurance discrepancies before the patient arrives.

When discussing insurance with patients, make sure your team explains your practice's financial policies clearly and discusses estimated out-of-pocket costs based on a patient’s insurance verification. They should review any prepayment requirements for services and outline billing procedures and payment options, including dental membership clubs. Finally, they should offer to answer questions about insurance or costs.

This level of clarity helps reduce patient confusion about their financial responsibilities and creates a foundation of trust between your practice and patients.

3. Simplify Complex Insurance Information When Talking to Your Patients

Medical insurance is filled with jargon that confuses patients. Simplify that complexity by:

• Replacing technical terms with everyday language

• Defining necessary insurance terms in simple words

• Aiming for a 6th-8th grade reading level in all patient communications

• Avoiding acronyms without explanation

For example, instead of saying "Your plan has a $2000 OOP maximum with 80/20 coinsurance after meeting your deductible," try "After you pay $2000 in costs yourself, your insurance will cover all remaining expenses. Before that point, you'll pay 20% of costs and your insurance covers 80%."

Additionally, you’ll want your team to make insurance information relevant by focusing on plan details most applicable to the individual patient. This can include highlighting coverage for their specific health conditions, explaining out-of-pocket costs for services they'll likely need, and using examples that relate to their personal healthcare situation.

Sometimes, visual representations can help your team communicate complex concepts better than text alone. Use visual aids such as:

• Creating simple charts comparing plan options

• Developing infographics explaining insurance processes

• Using icons to represent key concepts

• Providing side-by-side comparisons of coverage options

4. Focus on Patient-Centric Care in Insurance Discussions

Each patient comes with unique circumstances, goals, and challenges. Take time to understand their lifestyle, work commitments, and personal health objectives before developing any treatment plan. This personalization leads to better engagement and more effective outcomes than one-size-fits-all approaches.

Also, be transparent regarding the costs and benefits of different treatment options. This means having honest conversations about:

• Potential out-of-pocket expenses

• Insurance coverage limitations

• Cost-effective alternatives when appropriate

• Expected benefits of recommended treatments

5. Address Out-of-Network Scenarios with Empathy

Out-of-network status occurs when your practice doesn't have a contractual relationship with a patient's insurance plan, potentially resulting in higher out-of-pocket costs through balance billing (when you bill patients for the difference between your charge and what their insurance pays).

Explain out-of-network status clearly and empathetically, as that can make a substantial difference in patient retention. When discussing this situation:

• Use simple, jargon-free language that acknowledges their potential concerns

• Express genuine understanding about their financial constraints

• Offer to discuss options collaboratively rather than presenting it as a take-it-or-leave-it scenario

• Provide written cost estimates upfront so there are no surprises

Keep in mind that, when patients face higher costs, they need compelling reasons to stay with your practice. Emphasize your:

• Specialized expertise or treatments not widely available elsewhere

• Consistent care team and ongoing relationship that benefits their health

• Convenient location, extended hours, or telehealth options

• Track record of positive outcomes for similar cases

And finally, be sure to offer flexible payment solutions. This can look like implementing structured payment plans that spread costs over time, partnering with third-party financing companies for larger bills, setting up card-on-file systems for automatic, manageable payments, and considering sliding scale fees or prompt-pay discounts when appropriate.

6. Assist with Insurance Claims and Disputes

As a healthcare provider, you can significantly reduce your patients' stress by assisting with insurance claims. The best way to do that is to file claims directly with your patient's insurance company, typically submitting them electronically within 24-48 hours of service.

Explain the entire claims process to your patients, including the key steps: submission, initial review, verification, medical necessity check, and payment decision. Also, encourage them to keep detailed records of all communications with their insurer and to carefully review their Explanation of Benefits (EOB) statements.

If your patients' claim is denied, help them identify the reason. 

Common denials result from coding errors, lack of pre-authorization, or non-covered services. If that happens, assist them in gathering supporting documentation and guide them through the appeals process, whether it's an internal appeal to the insurance company or an external review by an independent third party.

7. Use Technology to Improve Communication

Technology offers powerful solutions to streamline insurance-related communications between you and your patients.

For example, patient portals serve as central hubs where your patients can access their health information, including insurance details, 24/7. These secure online platforms allow patients to view their insurance benefits and coverage information without calling your office.

Patient portals typically allow patients to:

• View insurance information and benefits

• Update their insurance details

• Make payments

• Send secure messages about coverage questions

• Download necessary insurance forms

There are also automated appointment reminders that help patients arrive prepared with necessary insurance information. These systems reduce no-show rates and save hundreds of administrative hours annually.

You can customize these reminders to include insurance verification prompts, co-payment information, or instructions to bring insurance cards.

Beyond patient portals, various digital tools can enhance insurance discussions with patients. Consider implementing:

• Two-way texting for quick insurance inquiries

• Mobile apps that store insurance information

• Video calls to explain complex coverage issues

• Secure messaging for sharing detailed benefits information

• Incorporating AI in dentistry innovations to automate routine communications and simplify insurance verification

8. Maintain Open Lines of Communication When Talking to Dental Patients

Ongoing dialogue with your patients builds trust and rapport. Encourage your patients to ask questions about their insurance details, treatment plans, and any concerns they might have. Create a welcoming environment where they feel comfortable voicing their doubts.

Give patients your full attention: make eye contact, nod to show engagement, and avoid interruptions. When they speak, paraphrase and summarize to confirm that you understand. Also, ask clarifying questions when needed to gain deeper insight into their perspective.

You can also provide educational resources to reinforce verbal explanations. These include written materials, access to reputable online resources, and visual aids to explain complex medical concepts.

9. Stay Updated on Insurance Policies and Regulations

Dental insurance policies and regulations can change frequently. And insurance companies typically implement major updates at the beginning of each year, effective January 1st, though some changes may occur mid-year as well. As a dental professional, you need to stay vigilant about monitoring these updates, which commonly include:

• CDT code revisions (Current Dental Terminology) with new, revised, and deleted procedure codes. For example, CDT 2025 includes 10 new codes and 12 revised codes

• Changes to coverage amounts and annual maximums

• Updates to deductible structures

• Modifications to covered services and exclusions

• Revisions to claim submission requirements

Failing to keep up with these changes can result in claim denials, billing errors, and patient dissatisfaction.

Better Insurance Talks, Happier Patients, Stronger Team

Talking about dental insurance doesn’t have to be complicated. When you clearly explain coverage, costs, and options, patients feel more confident about their care and are more likely to follow through with necessary treatments.

By keeping things simple and showing empathy, you can build trust and make the entire experience less stressful for your patients.

Training your team, using technology, and staying up to date with insurance changes can make these conversations smoother and prevent misunderstandings. Offering flexible payment options and helping patients navigate insurance challenges can also go a long way in keeping them happy and loyal to your practice.

But even the best processes rely on having a knowledgeable and reliable team in place. Teero can help by connecting dental practices with top-tier dental professionals to make staffing easier and more efficient.

A well-trained, supportive team will improve patient interactions and ensure smoother insurance discussions, better patient experiences, and stronger trust in your practice. Explore how Teero can help you build the right team to support your practice.