As we come to the end of another calendar year, some of your patients’ dental insurance maximums may be exhausted while other patients may need your assistance in using the insurance benefits they’ve been paying for throughout the year but haven’t used yet.
Patients often don’t understand how their dental insurance plan benefits work, and it can be a valuable service for your office to provide them with helpful advice about how much their dental insurance would pay if their treatment-planned procedures were completed this calendar year, or if some of their treatment plan completed this year and the remainder completed next year, or if they postpone all of their treatment to be completed next year.
To present these different options to your patients, you should first enter all the procedures to be included in the treatment plan into a single treatment case in Dentrix.
Completing All Procedures This Year
When you print the treatment case to present your patient, you can select the option to Use Dental Plan Maximums and Deductibles.
When you select this option, Dentrix will factor in when the dental plan maximum has been met, and any remaining treatment will be owed by the patient. This would show the patient how much they would have to pay out of pocket if all their treatment was completed this year.
Note: Dentrix automatically calculates procedures completed in your office and applies those to the patient’s dental insurance maximum, but any maximum amounts used outside of your office (for example, at a specialist’s office, or prior to becoming a patient at your office) would need to be manually entered for the maximum amount used to be accurate.
Completing Procedures Over Two Years
To present the patient with an option to split their treatment between this year and next, you can simply clear the Use Dental Plan Maximums and Deductibles option. However, you should be mindful that the deductible will only be applied once (not once for each year). Also, if you are working with a large treatment plan that contains multiple procedures, it may appear that the insurance will be paying more than what you would actually estimate because Dentrix will not be applying the maximum. However, you can always override the insurance estimate for a procedure, if necessary, in order to show the patient when they will meet their plan maximum.
Completing All Procedures Next Year
If the patient would like to see how much they would have to pay if they postpone their entire treatment plan until next year, you could first make a note of how much of their insurance maximum they have used in the Dental Insurance Benefits and Coverage dialog box.
After making a note, you could then edit the used maximum amount to zero, so it appears that no maximum has been used. You could also change any deductibles met amount to zero. Then print the Treatment Case for the patient, showing no maximum used and no deductible met. After you have printed the Treatment Case, be sure to go back to the Dental Insurance Benefits and Coverage dialog box and re-enter any maximum used and deductibles met. In this scenario, I would also strongly recommend having a detailed conversation with your patient about using most or all of their insurance maximum at the beginning of the calendar year, and the ramifications of what could be a very costly decision if they need any other treatment throughout the rest of the year.
The Dentrix Treatment Planner has all the tools you need to help your patients understand the financial benefits of proceeding with necessary treatment this year, splitting their treatment over two years, or what can happen if they postpone all their treatment until next year. Since most patients don’t understand how their dental insurance plan works, your office is providing them with valuable advice on how to make the best financial decision.
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By Charlotte Skaggs
Certified Dentrix Trainer and The Dentrix Office Manager columnist
Charlotte Skaggs is the founder of Vector Dental Consulting LLC, a practice management firm focused on taking offices to the next level. Charlotte co-owned and managed a successful dental practice with her husband for 17 years. She has a unique approach to consulting based on the perspective of a practice owner. Charlotte has been using Dentrix for over 20 years and is a certified Dentrix trainer. Contact Charlotte at [email protected].
