Billing & Insurance Bosses
What type of insurance plans are we primarily in-network with?
PPO plans. We do not accept Medicaid.
Where can you find important patient history notes in OpenDental around billing?
Check the commlog for billing notes. Lassie is our new payment posting software and will also place a note on the patient chart showing why insurance underpaid and where the patient balance is from.
What is the correct greeting when answering calls?
“Thank you for calling [Practice Name], this is [Your Name], how can I help you?”
If a new patient asks how soon they can get in, what option can move up their appointment?
ASAP List (cancellation list).
What should you never do when an inbound call is coming in for you?
Cancel or Ignore a call—always complete the attempt. When you click ignore, freshdesk will think you are not available even if your status is available.
True or False: If a patient is unsure about their in-network status, we should refer them to their insurance provider.
Some of our doctors may show as out-of-network while they are in credentialing, so we do not want to refer to their insurance company. Instead assure patients we are primarily in-network with all PPO plans and we will do a 278 point verification on their unique dental plan prior to their appointment.
When scheduling an existing patient, what are three things you should check before booking?
Pop-ups, family appointment history, and previous collections/dismissal status.
Why should important messages not be sent only in chat?
Important info gets lost in chat; send an email instead and reference it in chat.
When scheduling a new patient, why should we emphasize the doctor’s role in their visit?
It builds value—“The doctor is getting to know you and your dental health.”
It is more than "just" xrays and an exam. This is really where we are going to get to know the patient and provide a full 360 view and plan for their health that align with their goals.
What is one way you can increase connection rate after you complete a call?
returning online early and reducing wrap-up time.
What should you check for when entering new patient insurance details?
Verify accuracy, ensuring you have collected all information by asking discovery questions, and identify any errors before the appointment by looking ahead at the schedule.
If a patient has had 3 last-minute cancellations, what scheduling option should they be placed on?
Same-day appointment list for flexibility.
What’s a best practice for communicating lunch and break times in a remote setting?
Always inform your pod team members before going offline, making sure they are online and available to take calls.
What should you say at the end of a new patient call to set expectations?
Summarize their next steps and note pending items in the appointment notes that way we can follow up with the patient. (paperwork, insurance, confirm their appointment, cancellation notice, etc)
If a patient asks for an appointment via email, text, or phone, what method should you continue the conversation with?
Continue the conversation in that communication method, it is probably their preferred way of communicating since they initiated it. Follow all communication and scheduling standards no matter what avenue you are communicating through.
If a patient calls angry about a bill, what is the first step you should take?
Acknowledge their frustration, listen, and let them know we will research the issue and help them navigate their questions.
What is the best way to note outstanding patient items before an appointment (i.e. interested in HA, looking for insurance card, etc)?
Add them to the appointment notes
If a patient hesitates to book due to cost, what is a key reassurance phrase to use?
"We never want surprises when it comes to cost. We offer financing options like CareCredit, Sunbit, and our in-house membership plan to help make care affordable."
If a patient has not been seen in over 24 months, why do we schedule the same as a new patient?
A patient's health can change a lot in the 2 years since their last visit, so we will want to look at their comprehensive health.
What discovery questions do you ask to determine what type of appointment to schedule? (i.e. limited vs comp)
Ask questions around their goals and urgency to determine what appointment to schedule
When verifying a patient’s insurance, what is the most important details to confirm?
Correct spelling of name, subscriber’s date of birth, and insurance ID number (which can be called different things on the card depending on the carrier).
What should you always do before assigning a task to a clinical team member or a ticket to the billing team?
Include all relevant information needed for them to complete the task.
What is the correct response if a non-patient returns a call from our outbound efforts?
Explain that we were following up on their inquiry and see if they would like to schedule an appointment.
What’s a way to encourage a patient to schedule family members?
"Are there any other family members I can help get scheduled today?”
When a patient has concerns about the cost of a procedure, what is a good way to respond to assure them we have options and guide them toward scheduling an appointment?
"I completely understand that cost is an important factor when making healthcare decisions. The good news is that we have several options to make your care affordable and offer savings on your care.
The most important thing is to get you in for a visit so the doctor can assess exactly what you need and provide clear pricing with no surprises. I can go ahead and reserve a time for you—does [Option A] or [Option B] work best?