How to Handle Patient’s Insurance Objections

Jeff Palmer, founder of the Case Acceptance Academy.

What I want to talk to you today is about how to virtually eliminate the “I only want to do what my insurance will pay for” objection.

#1. Whenever you go into a case presentation, you need to know exactly what the insurance is going to cover for that patient. And now what I mean by exactly is that what the estimate is going to be. Because the patient, if they have insurance, is always going to want to know what the estimate on their insurance is going to be, even if it’s just an estimate. It will come up as objection and it doesn’t mean that they only want to do what the insurance will pay but if you don’t know that before you go in, then you’re going to have to have them leave the office and figure out their insurance coverage and have them come back later and that will kill your case acceptance.

#2. In order to eliminate the insurance objection, is you need to create an emotional connection between the patient and their dental problem. What do I mean by that? Patients will only do more than the insurance will cover this year if they believe it will benefit them. The fact of the matter is that the insurance out of pocket has been a thousand to fifteen hundred ($1,000 – $1,500) since 1970. So the cost of dentistry has gone up five or six times but the insurance benefit for all intensive purposes has stayed basically the same. Now, just because a patient has an insurance benefit doesn’t mean that you should treatment plan what their insurance will do this year because you think they’re only going to do what their insurance will pay. If you can create a connection between your diagnosis and the patient owning the problem and they have an emotional connection with that, meaning they have an active infection, they don’t want infection in their mouth, they want to get it out now, they’re out of insurance benefit for the year, they want to save their tooth, so they’re going to get the root canal post and core done now even though it’s August and they’re out of benefit because they want to get the infection out of their body and they want to save their tooth.

They will pay for that now if they have an emotional connection to the problem. If the patient does not have an emotional connection to the problem, then they will say “I just want to do what the insurance will pay, or I’ll wait until it hurts, or I don’t really care” and then you’re going to think that the insurance is the main reason why they’re not moving forward with the treatment, when in reality they don’t have an emotional connection to the problem.

So if you want to eliminate the insurance objection, first you need to know what their insurance will cover out of pocket even if you’re not accepting their insurance before you present that care plan before you present the treatment plan. And two, you need to create an emotional connection to that exact problem so the patient owns the problem and then they’ll be willing to step outside of their insurance maximum for this year and get the treatment done that you’re diagnosing they need because they need it not because somebody else can help them pay for it.


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