Home Forums Practice Management Systems Understanding Insurance and PPOs Reply To: Understanding Insurance and PPOs

Melissa Dunham


I agree with everything you said. with the exception of Pre-auths'/Ds. Practices really need to approach PRE-Auths/D's as a tool for the practice, and not so much for the patient. Pre-approvals can increase treatment plan acceptance, and suffice the role the a contracted practice has in disclosing non-covered benefits as deemed necessary in most contracts. The application of an comprehensive waiver to all tx plans regardless of t plan, is a strong compliment to the pre-approval/denial. All parties understand the financial outcome of treatment acceptance.

Pre-Authorizations allow patients to make a financial decision on the treatment proposed for them. We have a 98% treatment plan acceptance rate in our practice, and my system is improving other practices. Additionally, they take the stress away from financial discussions with eager patients, whom naively believe practices know everything about their dental plans. I could go on and on about how pre-authorizations and the maintenance of their data within practice management systems can turn a dental practice AR around and keep chairs filled, but it would be a lengthy write-up.

Dentistry is the only section of health care that does NOT do pre-authorizations for patients. With pre-auths, we help the patient tell them what they want to know and this is “How much will it cost”, and protect the office-patient financial relationship, empower treatment planning /scheduling staff with answers that they want to know as well.

Excellent Summary you gave, and I am relieved to see it as there are a great many who simply don't understand what is going on.