We love improving the lives of our patients by providing life-changing treatment. We don’t love the headaches caused by the paperwork that comes afterward. Like many healthcare providers, most practice owners have a bone to pick with insurance claims. 

From differing insurance policies between patients to securing relationships with insurance companies, insurance management is a nuisance. With a PPO practice, insurance management is even more complicated. It’s not as easy as an FFS practice, where everyone can get their treatment, pay in full, and be on their way.

Regardless of whether a practice is PPO or FFS, it’s vital for any dental practice to ensure their insurance management is being done properly. Someone dependable should be tasked with overseeing the claims you submit, making sure they check out, and so on. Otherwise, things can get ugly.

Some practice owners delegate insurance management to an insurance coordinator. Others outsource insurance management to a company. Choosing between having an insurance coordinator and outsourcing insurance management isn’t an easy decision. There’s a lot of advantages and disadvantages on each side, so let’s get into them.

Pros of Outsourcing

Outsourcing your insurance management can have a lot of advantages. Here are a few:

  • If you outsource it, you don’t have to worry about your insurance coordinator handing in their two-week notice. You won’t be left scrambling to find a replacement who will need to be trained all over again. 
  • You don’t have to worry about the additional cost of having an employee (covering taxes, sick leave, time off, benefits, etc.).
  • Outsourced insurance management typically charges based on a percentage of your collections. That means it’s in their best interests to work hard to make sure you make the most collections you can make.
  • Unless it’s a small company, you don’t have to depend on one person to get the job done right. You can depend on a whole team of people working together.
  • Unless you hire an insurance coordinator, not outsourcing insurance management means you’ll have your employees spending hours away from doing what they do best in order to play that role.

Cons of Outsourcing

As with everything, there are also disadvantages to outsourcing your insurance management rather than keeping it in-house with an insurance coordinator, such as:

  • If you don’t hire an employee to manage insurance in-house, someone in your community might miss out on a job.
  • When you outsource insurance management, there’s no in-person touch. You can’t direct those managing your insurance or communicate with them as easily. You’ll have to call. You might go through one person and then to another person and then to another person. The tedium of resolving insurance management issues can be frustrating for doctors—that time is precious and they’re better off treating patients with it. It’s much more efficient to have brief a word with your designated insurance coordinator in the office instead.
  • If an emergency patient comes in and you have to make that call, you end up fiddling your thumbs until they get back to you. You won't be giving the patient the treatment they desperately need as soon as possible.
  • Outsourcing insurance management may cost more than hiring an employee as they charge a percentage of collections rather than taking a salary or hourly wage.
  • A lot of the people processing claims at insurance management companies are timed. In other words, they're likely to rush things so they don't get fired. This could mean sloppy work. 

How to Keep Insurance Management In-House Effectively

Many practices prefer to keep insurance management in-house, but you can do so in a creative way. You don’t have to scour the web for an insurance coordinator nor agency. If you have an extra member on the team who you can put in that role, they might be your best option.

Believe it or not, your dental assistant may be well-equipped to take on the intricacies of managing dental insurance. The truth is, you can train anyone to become an insurance coordinator. In fact, it’s actually better if your insurance coordinator understands the clinical side of things. If they don’t know what a good x-ray looks like, or what a buildup is, or what a crown is, then they’re going to have a lot of trouble making sure your claims will get accepted.

It's up to You!

In the end, it’s up to you whether or not you want to keep insurance management in-house or delegate it to a company. If you choose to keep it in-house, your best bet might be to turn one of your existing employees into your insurance coordinator.

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