Stressed About Employee Salaries?

Coaching dentists to become confident leaders of a profitable practice

Responding to Tricky Insurance Questions


Are there some questions you wish you never heard again? For many dental teams, insurance related questions make them cringe. It begins on the phone with “Do you take my insurance?” This will be followed by “Why don’t you take my insurance?” And then onto  “Will insurance cover this?”  And finally, if the dentist has had enough of the whole issue, “Why are you leaving my plan?” 

Wouldn’t it be a relief if you had a professional, compassionate way to respond to these questions? In this article you’ll learn a framework you can use for any type of tricky question and get example scripts for those recurring insurance questions.

Tricky Questions Framework

I began my career as a corporate trainer specializing in experiential learning. There is a shortcut to developing training activities called frame games. Frame games have a repeatable format to fit any content. Let’s apply that concept to a verbal framework to help you respond to any difficult question posed by patients.

There are four components to this framework.

Respond to the feelingMany questions originate from an emotion such as anxiety, frustration or overwhelm. If you respond only with logic, you miss the subtext and the patient won’t feel heard. Your first step is to show you understand and have compassion for how the patient feels.
Share your philosophySharing your philosophy of care can answer patients’ “why” questions and provide a context.
Focus on the benefitsNow link your overall philosophy to specific benefits that the individual patient will value. It’s the WIIFM component.
Redirect with a questionThis should be dialogue, not a monologue. Ask check-in questions such as: How do feel about this? or What are your thoughts? Often, patients’ money questions mask a real concern about the value of treatment.

Let’s apply this framework to insurance.

Do you take my insurance?

Thanks for asking this. I know how important it is to have affordable dental care. That’s important to us too.

We focus on your health as well as helping keep your dental bills as manageable as possible. We’ll work with your plan by submitting your paperwork and helping you make the most of your benefits. Because we’re an independent provider with your plan, you’ll get your dental reimbursement sent directly to you.

You’ll find that we’re dedicated to providing personalized care.

If that sounds like what you’re looking for, then let’s schedule an appointment and I’ll be happy to check your benefits.

Can I ask you what you’re looking for with your new dentist?

Why aren’t you on my plan?

We researched many plans and made the difficult decision to be an independent provider. Our first goal is to provide exceptional dental care and we found that most plans compromise the kind of quality care we want to provide.

We’re an independent provider with your plan which means you and I decide on what care you need and when instead of having a third-party business interfere in those decisions. It’s a win for all of us because you still get to use your benefits along with leading edge treatment.

How does that sound to you?

Will insurance cover this?

It’s great that you have benefits to help reduce your out-of-pocket costs. Keep in mind, that most dental plans do not provide 100% reimbursement for what people need because that would not be profitable for them.  We’ll absolutely do our best to maximize your benefits so that your portion is as low as possible.

More importantly, how do you feel about this treatment plan? How committed are you to getting this treatment, especially if insurance won’t fully cover it?

I’m maxed out on my insurance, can we wait?

I completely understand how frustrating it is to have another unexpected expense. It sounds like you’re asking me an important question, which is, “Do I really need to do this and do I need do this now?”

It’s because I want you to save money, I’m recommending we do this ASAP. Here’s why…

Tell me, what is most important to you right now in terms of your health?

Why did you leave my plan?

Let me reassure you about what is and isn’t happening. We’ve changed our relationship with the insurance company; we haven’t changed our relationship with you.

You will still be a valued patient in our practice and we will still file your insurance paperwork for you.  We made this decision so that we can continue to provide the quality care you deserve

Feel free to work with your team and mix and match these responses until they are comfortable. I have additional tips and scripts on my website, including this article on treatment dialogues If you have a specific tricky question that’s driving you crazy, I’ll help you script your response.

Subscribe to the Bite-Sized Practice Management Newsletter: Tips, Scripts and tools designed for dentists in a hurry.​

Download the Dental Wage Planner

View your current payroll costs at a glance and forecast the impact of potential raises. You will be able to see any compensation inequities, compare payroll costs to your production and calculate the costs of proposed raises against your production goals. 

DOWNLOAD: The Stress-Free Guide to Attract World-Class Dental Employees

Sign up below and we’ll send you the free guide straight to your inbox

Inspired Us to Dream Bigger, and it Works

“As an Office Manager, I’ve seen a great difference in my practice since starting with Sharyn. Three years ago our staff was in turmoil with a lot of infighting and gossip and some jealousy directed towards me.

I had given up because everything I did was judged. Now I have learned to have more one-to-one communication and by being more vulnerable with individuals I found my leadership voice. As a team, we’re all focused on the same goals.

Last year, in August we produced $88,000. This year we’re on track to produce $111,000 this month. I know it’s because we learned how to follow through with patients and communicate our expectations while building our systems.

Sharyn has gotten us out of our comfort zone and inspired us to dream bigger and it works.”

–Sharon St Pierre, Sperbeck Dental Care

The Stress-Free Guide to Attract World-Class Dental Employees

You’ll learn how to