AADOM News |4 min read

The Importance of the Dental Insurance Breakdown Form [Part 1]

Ashley Bond with text, "Real-world insights from AADOM authors"

The dental insurance breakdown form may be the most crucial piece of information you ever use in your dental office. But why is it so important, and do we REALLY have to get a breakdown for each patient?

The short answer is YES.

There are three reasons this seemingly easy task is so vital to an office’s success.

1. The patient experience

The patient experience goes hand in hand with how well versed you are in their dental insurance.

You’re the dental expert. It is up to you and your team to know the ins and outs of their plan.

  • Are you a fee for service practice?
  • Does this patient have a plan on a very low fee schedule?
  • Does this plan have a 12-month waiting period for crowns?
  • How about downgrades; does this plan downgrade white fillings to amalgam on posterior teeth?

These are the questions that will make or break a patient’s experience with your office.

Patients do not mind paying their dental bills, but what they do mind is paying their SURPRISE dental bills.

Take the surprise out of the equation and get the most accurate and detailed insurance breakdown the first time you call.

While I do believe that insurance is always an estimation and never a guarantee of payment, I also believe that it’s our responsibility to give them the most accurate insurance breakdown that we can.

Not only will this courtesy set your office up for success, but it will relay to the patient that you know what you’re doing so they can have complete confidence in your team.

2. Collect 100%

A successful practice collects as close to 100% of their patient portion as possible, upfront and at the time of service.

As all my aging professionals know, the longer a balance is overdue or the farther a patient is from their date of service, the harder it is to collect that money.

How many times have you gotten a statement in the mail and not paid right away because you know you have time?

Don’t delay getting your doctor paid for their work.

When we get the best insurance breakdown we can, it pays tenfold in our collections, and when the office gets paid, ultimately, we get paid.

With accurate breakdowns, we’re able to collect that third perio maintenance at the time of service, when we know it will not be covered.

We may find out that the deductible applies to preventative, so we collect at their first cleaning appointment.

We collect on that occlusal guard since it isn’t a covered benefit for bruxism.

When you collect the day the balance is due, it’s better for the patient, the office, and you.

3. Your own growth and credibility

Ultimately, I believe that understanding a patient’s insurance plan is a growth opportunity for office managers.

  • Learn how each plan works
  • Learn what each clause means
  • Why was there a denial?

It builds credibility and confidence in your future with your current office or with another company in the future.

When I first started with no dental knowledge, calling insurance companies and getting breakdowns was one of the greatest tools to learn the basics of dental coverage. I took this time to ask a representative any questions I did not understand.

Through these conversations, my knowledge and confidence grew immensely.

When a patient asked me a question at checkout about their bill or their plan, my confidence shined through. It didn’t catch me off guard anymore.

Having a detailed breakdown performed for each patient gave me the confidence I needed and the knowledge I lacked.

Let your confidence shine! Ask questions and dig deeper for your own growth, credibility, and future.

Next week I am going to begin to go into detail on what each part of the insurance breakdown form means and why we ask these questions. Get your notes ready and in the meantime, go to my website to download my free detailed insurance breakdown form… This text opens a new tab to the website to download freebies… to follow along.

Meet the Author

Ashley Bond in black blazer and pearl necklaceAshley Bond is the founder of Bond Dental Consulting… This text opens a new tab to the official website…, a company specializing in remote dental billing, A/R, and dental consulting.

Her passion is to help practices stress less, collect more, and get back to what’s really important: the patient relationship.

Ashley has over a decade of experience in the dental field, beginner her career at her father’s dental practice. There, she learned the ins and outs of everything the business entails. She has played many roles, including treatment coordinator, office manager, marketing manager, and insurance guru.

Get all the latest dental tips and tricks on her weekly podcast, “Quick Bites for your Dental Office… This text opens a new tab to the podcast’s web page…,” and follow her on Instagram (@bonddentalconsulting)… This text opens a new tab to her company’s Instagram… and Facebook… This text opens a new tab to her company’s Facebook….


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