Written by: Jackie Ulasewich-Cullen
Medical and dental insurance are the norm for patients in the U.S., yet insurance literacy remains surprisingly low. Most patients recognize common terms like deductible, coinsurance, and out-of-pocket maximum, but they’d be hard-pressed to explain what they mean or how insurance influences their care options.
Dental insurance is particularly difficult for patients to grasp. It doesn’t follow the same rules as medical insurance, policy language can be opaque, and there’s a notable lack of cost transparency, among other things. This dearth of knowledge among consumers, combined with powerful marketing on the part of insurance companies, creates barriers for out-of-network dentists seeking to reach patients who need higher-quality care than what’s available through a limited insurance network.
The Harms of Misconception
Patients tend to make decisions based on immediate out-of-pocket costs rather than long-term oral health outcomes. They assume that staying within the provider network means they’re getting the best care at the lowest cost. They may not realize that their plan limits what their dentist can do for them.
Misconceptions about dental insurance benefits create challenges for dentists—especially fee-for-service (FFS) or out-of-network (OON) practices—who prioritize comprehensive, personalized care. When patients focus only on what insurance covers, they sacrifice quality and often end up paying more in the long run. Unfortunately, this important information is not widely publicized outside of the dental profession.
Caution: Approach With Care
Given the widespread lack of consumer education about dental insurance, dentists shouldn’t assume patients will automatically see the benefits of choosing an out-of-network or fee-for-service provider. For many patients, the term “out-of-network” has a negative connotation because they’ve been trained to conflate it with “expensive,” “not covered,” and, therefore, “inferior” care. Of course, dentists know better.
To help patients understand the value of OON care, a practice needs to reframe the conversation by providing the facts about:
- What dental insurance is versus how it’s marketed
- How insurance restrictions can limit treatment options
- Why being out of network has no bearing on quality
- How a fee-for-service practice can provide more personalized care
- Why long-term value is more important than perceived savings
When it comes to patients, the best approach is to provide information that helps them make better decisions, and that means meeting them where they are in their understanding. If the patient is unfamiliar with clinical jargon and insurance terms, as most are, use plain language to avoid confusion. If they’re scared or skeptical about not staying within their insurance network, be patient, listen to their concerns, and acknowledge their feelings.
Arming Patients With Facts
For a patient to take the leap from in-network to out-of-network care, they need convincing information that will eliminate their doubts. A single paragraph on a website won’t do it. Practices have to consider how and where patients consume information and provide a variety of avenues for them to find what they need to make an educated decision, including:
- Video content on the practice website and social media that introduces terms and concepts
- Long-form written content, like emails and blog posts, that delves into important topics
- FAQs to address the most common questions and debunk myths
- Lighter content, such as social media posts, to share experiences and tips
- Online resources that provide facts about hot topics, like submitting insurance claims and cost expectations
- Visual media posted in the office and printed material for patients to take home
In addition to providing sufficient online information, all staff should be prepared for in-person conversations. Regardless of their role within the practice, every team member who interacts with patients should be comfortable answering questions about out-of-network care over the phone, via email, and in person.
Building Trust Through Education
Educating patients means connecting with them. A patient is more likely to trust their health to a dentist who answers questions and explains without judgment or pressure to make a decision right away. The most successful FFS practices view patient education as SOP. They create consistent, meaningful content geared toward increasing patient awareness and conduct regular training sessions to keep staff informed and prepared. They don’t vilify insurance. Instead, they aim to empower patients by explaining the benefits of OON care, where the dentist makes treatment decisions based on the patient’s needs rather than an insurance company’s criteria. They share real patient success stories that demonstrate those benefits.
Making a Difference
There’s no denying that some patients are apprehensive about choosing a fee-for-service practice, but with the right approach, it doesn’t have to be a deal breaker. With consistent, approachable, accessible content that’s available across multiple channels and an educational mindset, FFS practices can position themselves as patient advocates rather than insurance outsiders.
ABOUT THE AUTHOR
With more than a decade of experience in corporate dental laboratory marketing and brand development, Jackie Ulasewich-Cullen decided to take her passion for the dental business and marketing to the next level by founding My Dental Agency.
Since starting her company, she and her team have helped a wide variety of practices nationwide focus their message, reach their target audience, and increase their sales through effective marketing campaigns.
She can be reached at (800) 689-6434 or via email at [email protected].
FEATURED IMAGE CREDIT: Bruno Pereira from Pixabay.
