Verbal Skills to Move Away from PPOs

Episode #439 with Jenni Poulos

Dropping bad PPOs can be daunting. But there is one thing you can do to make the process a little more comfortable — utilizing verbal skills. Different words carry different weight, and Kirk Behrendt brings back Jenni Poulos, one of ACT’s amazing coaches, to explain how a small change in language can make a big difference in perception. By improving your verbal skills, you will build trust, value, and confidence. And, ultimately, you will retain the patients you want to keep in your practice. To learn how, and to learn more about ACT’s free Say This, Not That resource, listen to Episode 439 of The Best Practices Show!

Main Takeaways:

Language matters — your words carry weight.

Your team needs to be aligned on language.

Think of ways to phrase things with a positive spin.

Tell patients what you can do, not what you can't.

Eliminate fear and communicate confidently.

Quotes:

“The things that we say do carry a lot of weight. The language that we use — people have preconceived notions. They have stories that they tell around words. So, the language that we use matters. The safety that language can build, the trust that it can build, it is going to help your team navigate their own fear and stress around this and help move your patients through any fear and stress that they have about this transition [from PPOs]. So, you need to practice this, to lean into this, to give it plenty of time to have this transition be successful.” (3:14—3:50)

“The person that answers your phone doesn't represent your business — he or she is your whole business if I don't know you. And the care and skill and eloquence of someone at the phone determines a lot of your success.” (3:58—4:12)

“We don't think about this. Our clinical team comes in with extra school. Our hygiene comes in with extra school. And our administrators come in, and they are expected to execute a ton of tasks every day that they’ve received no additional training in. And we, as dentists, as managers, as those running the practice, we’re responsible for filling that gap and giving that training to our admin team members.” (4:41—5:12)

“Everyone on your team needs to be aligned around the language that you are using when you decide to make these transitions [from PPOs]. And you're going to practice, practice, practice, practice, and everyone is going to be comfortable and confident with the message that you're delivering.” (5:17—5:35)

“I absolutely believe that when we make the decision to transition away from PPO in-network status, this conversation begins chairside with our patients. There's a different level of trust that exists, oftentimes — not oftentimes, the majority of the time — between doc and patients, between hygienists and patients. And we don't want our admin bearing the brunt of this conversation. We want our clinical team to be starting the conversation about this transition [from PPOs] from a place of what our core values tell us about how we practice dentistry and why we are making this transition, and then we can move it up to the front for admin to fill in gaps.” (5:48—6:34)

“Many, many docs that I have been lucky enough to take through this transition of decreasing their dependency on insurance, the first question always is, ‘I don't even know where to begin this conversation.’ There's so much fear tied to it. And I would say, ‘What does it mean for you to practice dentistry with your core values at the forefront?’ Because when you can answer that question, you can succinctly tell your patients why this transition — because just like you said, you didn't get into dentistry to join a thousand PPOs and to write off a third of your paycheck. But I bet your core values tell you quite a bit about why you got into dentistry.” (8:44—9:24)

“Get rid of the limiting belief that, ‘My patients will only see me because I am on their insurance plan.’ I want you to throw that out the door, and I want your team to throw that out the door. Your patients come to see you because you are valuable, and because of you. And you need to own that and believe that. And we’re going to begin communicating from that place, of the belief that, ‘The patients that value me, that value the service, the valuable service that I provide, are going to stay here.’” (12:23—12:57)

“People have to come to you because of you, not because of their plan, not because of how cheap you are, or anything like that.” (13:19—13:25)

“People’s conditions change. So, you might say to yourself, ‘Well, I only have a certain percentage of my practice that's on a PPO.’ Well, you don't understand that they're part of an employment group that could change their participation in a second, and their plans. And so, with that comes a shift in your patient base. So, you can't necessarily set the winds so that you're going to be able to keep up with these patients. Their conditions change over time, and they can jump from PPO to another PPO in a second. And so, it’s really important to position yourself long-term that, ‘We are the people that care about you the most.’” (14:10—14:50)

“[Ask] patients, ‘What's important to you?’ What a great question that people don't ask. And it is a value builder, just asking people, ‘What do you value? What's important to you?’ This is going to lead them to believe that, ‘Hey, there is something different here.’” (14:59—15:22)

“I don't want you to overthink this process and get into these crazy, long, scripted conversations. But really think about, ‘What do my values say? Why are we doing this?’ and a simple statement from there. And then, really, it’s about, ‘What can we still do for you?’ I always want you to be approaching these conversations with, ‘What can I give you?’ the value that I can give you, that we’re still insurance-friendly. We’re still going to process claims for you. We’re still going to be your advocate. We’re going to still provide you with amazing care. And it should be as simple as that.” (15:45—16:28)

“There is always a way to phrase something that has a positive spin.” (17:48—17:53)

“With so many of these questions that we get from patients and entering into the unknown of this transition [from PPOs], there is a lot of, ‘I don't know what I don't know.’ And with that comes a tremendous amount of fear. Docs have fear about, ‘Oh my gosh, am I going to lose all my patients?’ Their patients have fear because they don't know any better. We come from this belief of insurance that we have to see the person that is in-network. And it’s simply not true when it comes to dental benefits, except for a very small percentage of plans in which you have to see an in-network provider to get benefit coverage.” (20:19—21:00)

“We oftentimes get confused, concerned, and sometimes angry patients because we don't have the skills, we’re not equipped with the answers that we can confidently say, ‘This is what I'm going to do for you, and this is why we have made these decisions.’ So, we’re going to knock out the, ‘I don't know what I don't know.’ We’re going to eliminate the fear, and we’re going to practice together so we can confidently communicate these things to our patients.” (21:20—21:52)

“We oftentimes talked about the difference between talking about the fee of something or the cost of something versus the investment of something. I love this example in the Say This, Not That because a fee or a cost, it’s money out the door. An investment has a return.” (23:59—24:15)

“‘We’re out-of-network.’ This is a big one. ‘We’re out. We’re a non-participating provider. We’re out-of-network.’ I really like the shift to, ‘We’re an unrestricted provider.’ Because it’s like, we’re not out-of-network — we’re able to provide care without restrictions to you. So, it’s what, positively, we can do for you. And also, we’re not out-of-network — we’re insurance-friendly.” (25:40—26:11)

“Even fee-for-service, if someone has a little bit of dental acumen, they might hear fee-for-service as, ‘You're going to do nothing to work with my dental benefits.’ They may have come across that phrase at some time. Telling people, ‘We are insurance-friendly,’ we’re going to advocate for you. We’re going to help you get coverage. We’re going to send the claims or provide you with the claims, the X-rays, the narratives, the resources that are necessary to get your coverage.” (26:18—26:50)

“Your ability to communicate will determine how far you go in dentistry. So, don't ever stop improving how you communicate.” (30:16—30:25)

Snippets:

0:00 Introduction.

2:17 Why language skills are important in a dental practice.

4:28 Your admin team gets the least amount of training.

5:35 Where to begin.

6:34 Eat and breathe your core values.

10:32 Have a framework for responding to questions.

11:58 Get rid of your limiting beliefs.

14:53 Be equipped with the right questions.

16:59 Tell patients what you can do for them.

19:30 Eliminate the fear.

22:24 ACT’s Say This, Not That document. 

28:11 You get to decide what you say.

30:26 Last thoughts on verbal skills.

Reach Out to Jenni:

Jenni’s email: jenni@actdental.com 

Jenni’s Facebook: https://www.facebook.com/jenni.poulos

Jenni’s social media: @actdental

Resources:

ACT Dental Say This, Not That document: https://form.jotform.com/221665137804153

Jenni Poulos Bio:

Jenni brings to dental teams a literal lifetime of experience in dentistry. As the daughter and sister of periodontists and a dental hygienist, she has been working in many facets of the dental world since she first held a summer job turning rooms and pouring models at the age of 12. Now, with over 10 years of experience in managing and leading a large periodontal practice, she has a firm grasp on what it takes to run a thriving business. Her passion for organizational health and culture has been a driving force behind her coaching career. She has witnessed firsthand how creating an aligned and engaged team will take a practice to levels of success that they never believed possible! 

(Video)

5 Reasons You Do Not Bill Medical for Dentistry

Episode #438 with Laurie Owens

There is a list of dental procedures that medical insurance might pay. So, why do dentists avoid billing medical? Today, Kirk Behrendt brings back Laurie Owens, director of medical billing at Devdent, to share five reasons you don't bill medical, why you should start, and what you can do to increase claim acceptance. And the benefits go beyond reimbursement! To learn how medical billing can add value to your practice, listen to Episode 438 of The Best Practices Show!

Main Takeaways:

Get a complete health history of your patients.

Understand why a procedure needs to be done.

Ask the right questions — not yes or no questions.

Don't give up billing for medical after one try.

If your claim is denied, call and find out why.

Medical billing won't answer all of your problems.

Quotes:

“We sometimes are so rushed in dentistry that we forget that these are people with stories. And literally, medical billing is telling their story. And I think if we [don't] slow down a little bit and realize that there could be a story here, we’re not going to get it. We’re going to just rush, rush, rush, fill the schedule, and not realize there was a story that we missed.” (3:40—4:05)

“My number one [reason you don’t bill medical], you have an incomplete health history. And sometimes, it’s not the practice’s fault. But here’s what the patients think: ‘This doesn't have anything to do with my mouth.’ But are we asking? Are we making sure they understand the importance of — there's actually a video out by Delta Dental that talks about how many diseases the dentist can find. This is not something the medical doctor finds, it’s what the dentist can see. And people see their dentist more than their medical doctor. I've seen my dentist five times more than my doctor. So, if that's the case, and you know that these are all within the scope of your license, why should you not be paid for them?” (8:45—9:38)

“Are you letting your patients know, ‘This complete health history provides us enough information that if we can maximize your benefits through medical, we would have the documentation to do so’?” (10:38—10:49)

“We have to learn how [a health condition] has affected their lives in order to be able to tell the story. If you have a cancer patient, and now you're seeing them, and they can't eat because of the sores in their mouth, and you don't know it, how is that really effective treatment planning for a patient? It’s not. So, we have to ask them how these things have affected their lives, how they're physically feeling — especially if they have to change medications.” (13:31—14:02)

“A lot of people will say, ‘Well, it’s a lot of work.’ But did you know it could help your dental insurance claims too? By being thorough, you are helping your dental claims go through faster when you have all this documentation.” (14:37—14:52)

“In medical, they say, ‘If a patient says it, put it in quotes.’ You don't have to say that that's what you said. If the patient says it, put it in quotes. But asking the right question — quit asking yes or no. Ask them to tell you about it. ‘Tell me about when they found your diabetes. Tell me about when the doctor diagnosed that GERD for you. Tell me what happened. When was that? Were you older, younger? Did you have any other complications, other than what we’re sitting here for today? Tell me about that.’ They're always interested.” (14:54—15:31)

“[Reason] number three [for not billing medical], you're only looking to fill the schedule. Now, I'm all for filling the schedule. Please don't get me wrong. I agree, you should fill the schedule. But my number one is, if I say, ‘The doctor has some open time today,’ then, apparently, he’s not very good at his job. Or you're going to fit this patient in to inconvenience these other patients. And that doesn't make any sense.” (15:39—16:15)

“If it’s an emergency, medical will still pay. So, I get emergencies. And one thing that our practice learned from ACT was to make sure you know where those spaces are that fit best. So, have somebody in the clinical team make a note, ‘This is the best time for an emergency patient.’ Because without that knowledge, and oh my soul, we went years and years without that knowledge. And I can't tell you how much that saved us from chasing an assistant or wanting an assistant to murder us. I mean, it was life-changing for me. And so, that is what a coach helps you with. Finds these little bitty areas that could still fill your schedule, but not impact your current patients.” (17:42—18:32)

“[Reason number four for not billing medical is] because you lack in training. And that's one of the reasons we've kept our training costs low, is because we know coming out of COVID-19 you have so many expenses that were not planned on, were not budgeted for. So, we’ve really kept our costs low. But I've had offices that I said, ‘No. No, you can't do medical billing. You've got to get a coach to get this set first.’ If you think medical billing is going to answer all your problems in the practice, you're wrong. It’s not. It’s going to enhance your practice, absolutely. But don't feel that it’s the answer to your money problems for the practice, because you're going to be only focused on the dollars.” (19:55—20:52)

“How many more new patients could you get because of that one patient who says, ‘Hey, they billed my medical for this’?” (23:10—23:17)

“[Reason] number five [for not billing medical], you tried it once and it didn't work. You tried it once. I always say, ‘Tell me what you coded.’ And I guarantee you they coded it out of sequence and they're not going to pay. Whereas, if you would've looked at what their reason — and sometimes, medical doesn't give you the full reason. I got denied because I didn't have a zero in the ICD code set. Not because of my codes, but because the zero wasn’t there. I also got denied because my X was outside of the box. So, if you don't know — doctors will get a denial and they won't even call. They won't even find out, ‘Why is this denied?’ Because they're always going to say, ‘Denied for medical necessity.’ That's just the standard reply. Until you call, you're never going to know. It could be something little, like my X outside the box.” (25:04—26:13)

“A lot of doctors think, ‘Okay. Well, this worked for the exam, so I'm going to use it for the surgery.’ Well, there are certain requirements, if you would. So, you can't use a symptom for surgery. It doesn't make sense. We talked about that GERD patient that the prosthodontist was working on. If I used that he had GERD, but I didn't tell them what I was fixing, that won't make sense. I need to tell them I'm fixing the erosion because of the GERD. So, the story goes together. And a lot of doctors will say, ‘Well, he’s in pain.’ But that doesn't tell them what you're fixing. You're fixing the abscess that the pain came from.” (27:16—28:09)

“Medical changes every three months. So, that's why I have to constantly be studying what are the changes for this quarter.” (31:35—31:42)

“Most offices have no idea what their dental claim looks like. There is nothing different on the dental claim than the medical claim. This is new. The diagnosis codes, the modifiers — everything. If you print out your dental claim from your practice right now, it will show you ICD-10 codes. It’ll show you where to put units. This is something we don't do in dentistry, right? We put every line, surgical extraction, surgical extraction, surgical extraction. Instead, it’s one line with the amount of teeth that you took out. So, things are changing, even on the dental insurance, to conform more like the medical insurance. But there's nothing different on the medical insurance form than the dental insurance form right now.” (32:59—33:48)

“Whether you think you do or not, you do medical procedures. Most doctors don't realize, we don't get paid for bone grafting because it’s a medical procedure. You don't get paid for membranes because it’s a medical procedure. How about your cone beams? They're medical. There's a reason why dental insurance doesn't pay for it. And it’s not that they're trying to be mean. Those are truly medical procedures. So, why are we writing them off or not charging for them because dental insurance doesn't pay when there's a reason why?” (35:25—35:59)

Snippets:

0:00 Introduction.

2:26 Laurie’s background.

6:22 Why you should learn about medical billing.

8:36 Reason you don't bill medical 1) Incomplete health history.

12:50 Reason you don't bill medical 2) Not asking the right questions.

15:37 Reason you don't bill medical 3) Only looking to fill the schedule.

17:40 Have time set aside for emergencies.

19:50 Reason you don't bill medical 4) Lacking in training.

22:18 Invest in...