Talking About Insurance Without Hurting Case Acceptance

About this Guide

A dental plan pays by its own rules, not by what the patient needs. This guide gives the dentist and the team member who presents fees 1 shared order for every treatment talk: Need, Options, Fee, Plan Help, Next Step. The dentist explains the need and the options and hands off. The coordinator says the fee first, then what the plan is expected to pay, and books the next step the patient chose. Inside are scripts for the hardest insurance questions, the dentist's chairside handoff, a worked example of which fee the patient's part comes from, what to say when the plan pays less or nothing, phasing around the yearly maximum, word swaps, the lines you never cross, and 4 worked examples. Facts come from public sources: the American Dental Association, ADA News and the ADA Code of Ethics. Tips and advice with no source are Chairlink's own. Patients and dollar amounts are made up, except 1 example from an ADA page. Plan rules, contracts and state rules vary, so the guide tells you when to check.

Some patients ask "Is it covered?" before they know what their tooth needs. It's a fair question. Answer it briefly and honestly, then bring the talk back to the need, so the plan doesn't make the treatment decision.

This guide gives dentists and the team member who presents fees 1 order for every treatment talk:

1. **Need.** The dentist explains what they found, and why it matters.

2. **Options.** The real choices, including waiting, with the good and hard parts of each.

3. **Fee.** The fee for the care the patient chose, said in dollars.

4. **Plan help.** What the plan is expected to pay, and the patient's part.

5. **Next step.** When the patient chooses care, book it, set payment, sign. A patient who wants to wait gets a follow up day.

**Try this tomorrow.** When a patient asks "Is it covered?" before the need is clear:

"Your plan may help with part of it, and I'll show you exactly how much in a minute. First, can I make sure you're clear on what Dr. [Name] found? That's what we're solving."

**Inside the full guide:**

• The dentist's chairside handoff, word for word
• Answers to "I'll just do what insurance pays for"
• Which fee the patient's part comes from, in a worked example
• What to say when the plan pays less, or nothing
• Phasing around the yearly maximum, only when the dentist says it can wait
• 12 word swaps, the lines you never cross, and 4 worked examples

**Download the Full Guide**

What changed in v1.0

First release.

Guide Information

Chairlink Guides are general educational and informational resources. They are not medical, dental, legal, financial, employment or other professional advice.