Dentaltown August 2017 - 55

by Teresa Duncan, MS
With more than 20 years of
health care experience, Teresa
Duncan addresses topics such
as insurance coding and revenue
management. She received her
master's degree in health care
management and is a member
of the Academy of Dental
Management Consultants,
National Speakers Association.
She was recently named one of the Top 25 Women in
Dentistry and has provided consulting assistance in
the development of the American Dental Association's
Guidelines for Practice Success.

experienced of insurance coordinators to predict, with
any level of certainty, how a patient's plan fluctuates
from year to year.
When the team finds it difficult to keep up with the
changing insurance landscape, they could incorrectly
quote benefits and the patient's portion, which erodes
patient trust and confidence in the team. Lack of
confidence may cause the team to be less comfortable and
confident discussing costs, payment options and benefits
with the patient. This uneasiness is then transferred to the
patient, both verbally and through physical cues, making them
hesitant to accept recommended treatment.
Additionally, shared network changes and expansions have
delivered an unexpected stream of new patients that the doctor
may not be aware of or prepared for, especially in terms of having
to abide by a lower fee schedule. These changes muddy the water
and take away the clarity that used to exist. Your coordinators are
struggling daily to identify which fee schedules apply to your new
patient and to catch explanation of benefits with incorrect approved
or allowed fees.
All of this has left insurance coordinators in an unenviable
position. Patients expect the dental team to be as up to date on their
individual insurance plans as their pharmacies and primary care
physicians are. The difference is, with dental insurance, electronic
eligibility is not available as readily as it is in medical health care
practices. Because tracking changes in dental insurance requires
increased effort, it's important the team understands the why
behind the work.
Being as accurate as possible when estimating the patient's
portion will prevent the practice from losing revenue on the back
end. When you don't know the patient's responsibility or when
insurance is underestimated, the team is left with no option but to
bill patients after care has been delivered and chase money already
earned. This, I believe, is not only frustrating for the entire team,
but also a waste of valuable human and financial resources.

FREE FACTS, circle 6 on card

dentaltown.com \\ AUGUST 2017

55



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Table of Contents for the Digital Edition of Dentaltown August 2017

Dentaltown August 2017 - Intro
Dentaltown August 2017 - Cover1
Dentaltown August 2017 - Cover2
Dentaltown August 2017 - 1
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Dentaltown August 2017 - Cover3
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