Insurance Hassles

Insurance Hassles

One of the biggest time wasters for the staff of many practices is all the insurance issues that have to be dealt with in a day. Although less than 50% of the population has insurance coverage, it seems like a much higher percentage than that just due to the time needed to handle the associated hassles.

Our company is just in the throes of arranging a health benefits plan for our own staff. I have always resisted doing this because they are a big hassle for our company to administer too. Plus I feel that the middle man (the insurance company) must be making money somewhere between us and the provider so that means we are paying more for our services. However, our staff really wanted the plan and so we are going for it.

But in reviewing all the different rules and limitations on coverages, my sympathy went up even higher for the staff in practices who have to deal with this. I talked with a veteran staff member about this yesterday and got an earful of insurance woes.

What’s the Bottom Line?

From the perspective of my own staff, it is a great benefit for them and will encourage them to get out and take care of their health more. It also makes it easier for them financially as the cost is spread out monthly rather than in big lump sums that are usually not planned for.

However, one of the cautions that I have pointed out to my staff is that the policy is NOT intended to fully cover all of their health needs, only a percentage of it. They are still responsible for the rest of it. In the case of dentistry it amounts to about 50 – 80% coverage of what they will actually need. They still want it.

Dealing with this at the Front Desk

In a dental practice, for example, one could have a heart to heart chat with each new patient who has a policy. One could ask the patient how many teeth they would like to retain until they don’t need them anymore. That makes them think about it and you should work to get their agreement that they would like to keep all of them if possible. Then let them know that it is great that they have a policy to cover some of the care that will be needed, i.e. about 50% (80% of an old fee guide usually, and 50% for certain procedures). Let them know that SOME coverage is better than none and that they have an advantage over patients who have no insurance at all. Get their agreement that while you will access everything that is legally available in their coverage, they will need to pitch in whenever needed in order to make that goal of keeping as many teeth in their mouth till they don’t need them anymore.

For chiropractors, as another example, many policies only cover about 12 visits in a year, which for many patients is totally inadequate to fully handle the physical condition they are presenting. And so a similar conversation needs to be had with those patients.

And so it goes for all the private practices that are not covered by provincial health insurance.

Bottom, bottom line

The policies are intended to ASSIST the patients and that is what they need to fully grasp in order for you to get them to accept the full care they actually need or should have despite the partial coverage by insurance.

Good luck and do well with this!


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