Episode 416: “Do You Take My Insurance?” What Patients Need to Hear Before the First Visit

Don Adeesha: If your practice is out of network, you hear one question more than any other. Do you take my insurance? What happens next? 10 seconds can decide whether that patient ever books. Welcome back to the Less Insurance Dependence Podcast. I’m your host, Don Disha. It’s great to have you all here with us. I’m here today with Naren Arulrajah, CEO of Ekwa Marketing, and today we’re talking about how to answer the insurance question on the phone and on your website. So patients arrive ready for the conversation instead of be surprised by it. Naren, welcome to the show.

Naren Arulrajah: Hey, Don. So nice to be here. I think it’s a very important topic we are gonna be covering today. And this is a topic, unfortunately, a lot of practice owners and practices get wrong. And because of that, they lose literally thousands and thousands of dollars of new patients every year. That’s great. So I’m so glad to jump in and solve this.

Don Adeesha: Appreciate that, Naren. So let’s dive right into it. When a patient calls an out-of-network practice, what’s usually the first thing they ask and what happens to the call after that? If your practice is out of network, you hear one question more than any other. Do you take my insurance? What happens next? 10 seconds can decide whether that patient ever books.

Don Adeesha: This is a topic, unfortunately, a lot of practice owners and practices get wrong. And because of that, they lose literally thousands and thousands of dollars of new patients every year.

Naren Arulrajah: See, I was doing some research recently about how the insurance works, right, just to get some accurate numbers. And one of the things I found out is about half of American adults have some form of insurance. The other half do not have any form of insurance. So there are two huge camps, those with insurance and those without insurance. And for those who have insurance, 60, 70% of them have insurance that is at least two-thirds paid for by the company, meaning, the company pays the premium, at least two thirds of it, right? Now, the rest, it comes out as a payroll deduction. But when it comes to employees, many people get one third paid for by the company and the rest paid for by the employee. So on a monthly basis, the average person might be paying $60 for every family member for dental insurance.

Naren Arulrajah: So when you multiply 60 by 12, that’s $720. So they’re paying a lot of money without realizing it for this insurance. So the good news for you as a practice owner is once you understand how this insurance game works is you can use it to your advantage because many practices, for example, have a membership plan. Membership plans, from my experience, cost less than 400, $450, depending on the practice, depending on the location. So you can save your patients money, a lot of money every year by educating them, by building a relationship with them, by getting to know them. But you can’t do any of this till you build a relationship, till you get to know your patients. So don’t overthink this. And what typically practices would do is, when the patient says, "Do you take my insurance?" What practices will immediately say is, "No, we don’t." But, and this is the challenge with human beings, when you have been yelled at by somebody once upon a time, that negative experience is in your mind. So on a monthly basis, the average person might be paying $60 for every family member for dental insurance. 

Naren Arulrajah: So you can save your patients money, a lot of money every year by educating them, by building a relationship with them, by getting to know them.

Naren Arulrajah: We don’t remember the pain. For example, going back to our fight or flight part of our brain, when a tiger is chasing us, we are going to run away from it. We are gonna get on a tree or find a place where the tiger can’t get to us. That’s because we are here to survive. We are here to live one more day. That’s in our DNA. So that negative experience is like that experience with the tiger chasing you, we run away from it. So when a patient literally, without any prejudice, without any kind of bias, just says, "Hey, do you take my insurance?" The answer should be, "Absolutely, we take your insurance. Absolutely, we have many, many, many patients with Delta who are currently with us.

Naren Arulrajah: We have an insurance coordinator who’s here to help you collect every single penny, and that’s what we do. We fight for you and we’ll help you get every penny. But the way it works is you pay at time of service and then we file the paperwork and you get reimbursed before your credit card statement is due in the first place. So that’s how it works. And the other thing they don’t do is they don’t build a relationship. They don’t build a rapport. There’s a human being under that question, right? We all ask questions we know. We don’t ask questions we don’t know. For me, when I go to a car dealership, the question I ask is how much does this repair going to cost me? Because that’s the only question I know because I don’t know anything about cars.

Naren Arulrajah: I don’t know what is a carburetor, what is this or what is that? So I trust the person I’m dealing with and I ask them how much this is gonna cost. It’s the same way they’re asking you, do you take my insurance? Like they got a free benefit. They didn’t pay for it. They don’t care for it. They’re not too happy with it. But they wanna make sure that free benefit they got. Think of it like sometimes during Christmas we get free gift cards, right? We don’t go to that particular store, but we have a gift card. So we are like, "Hey, as soon as you walk into the store, can I use this gift card?" Of course, because that’s why you came there, you had that free benefit, right? So I think there’s a lot of psychology, a lot of things that has to be undone because most practices that go from taking that insurance to not taking that insurance is still acting like the old practice that was taking that insurance. So when a patient literally, without any prejudice, without any kind of bias, just says, ‘Hey, do you take my insurance?’ The answer should be, ‘Absolutely, we take your insurance.

Naren Arulrajah: There’s a human being under that question, right?

Naren Arulrajah: It’s like imagine you take somebody in and you train them on how to be a great waiter in a very high-end restaurant. But unfortunately, let’s say the last 25 years, that same person was in a fast food restaurant where there’s no relationship, there’s no rapport, and all of a sudden you throw them into this new environment because you, as the owner, decided you’re gonna be this high-end restaurant, i.e., they’re not gonna take that PPO plans anymore. Nobody trained them, nobody worked with them, nobody coached them, nobody’s helped them see the world differently. So there’s a lot of nuances that has to be unpacked in this simple question. And of course, having done this for 19 years now, almost 20 years, in a few months, I have seen the horror stories, I’ve seen the ones who have successfully navigated.

Naren Arulrajah: They have made the transition. They have gone from being a PPO practice to a fee-for-service practice or dropping just one or two plans, the ones that really are not worth it because you’re losing money on those plans. Nobody trained them, nobody worked with them, nobody coached them, nobody’s helped them see the world differently.

Naren Arulrajah: They have gone from being a PPO practice to a fee-for-service practice or dropping just one or two plans, the ones that really are not worth it because you’re losing money on those plans.

Don Adeesha: Appreciate that, Naren. Now you explained very comprehensively regarding what to do when a patient calls in, but what about the website? So what should a fee-for-service practice’s insurance page say and what should it never say?

Naren Arulrajah: Yeah, that’s a great, great, great question. You have to be honest, right? So I would say what you actually do on the insurance page, but most people are not gonna read that page. The other way I think about it is, how do I attract people who don’t have insurance? Or how do I attract people? Remember, as far as the patient is concerned, this is just a payment method. This is one more way to get picked. So how do we attract a whole group of people? So I would talk about the fact that you have many patients who are with Delta and so forth and so forth. I would talk about the fact that you have an insurance coordinator who’s gonna get every penny from the insurance companies on behalf of your patients.

Naren Arulrajah: I would also talk about the fact that you have payment plans. For example, if you have, especially the things that insurance doesn’t cover anyways, like the cosmetic, the bigger cases, what kind of payment plans can the patient work with? So for them, it becomes a manageable fee on a monthly basis versus this huge $20,000 bill upfront. So I would share all the information about how you make it easy for patients to come and see you, how you take care of them, and so forth.

Don Adeesha: And where else in the journey do cost expectations get set or go wrong? Remember, as far as the patient is concerned, this is just a payment method. This is one more way to get picked.” 

Naren Arulrajah: So for them, it becomes a manageable fee on a monthly basis versus this huge $20,000 bill upfront.

Naren Arulrajah: Yeah, so I think the number one place where it goes wrong is the phone. And it’s because the minute somebody hears the word no, right? If I say, "Do you take Delta?" And the first word out of the other person’s mouth is no, person stops hearing at that point. They are no longer listening, they’re no longer paying attention, they are no longer into the conversation. So your role is to break that cycle. And part of it is subconscious. Most people, if you ask them, no, no, no, the patient said, "Are you in network?" But when you listen to the calls, you will realize the patient never said, "Are you in network?" They just said, "Do you take this thing that I have, which is a benefit I have called Delta, do you take that insurance?" And that’s what they’re asking.

Naren Arulrajah: And you can say, "Yes, we have many patients with Delta. We are here to help you collect every penny. You know, Delta only covers certain things." So the insurance coordinator, what they do is they work with Delta to get every penny that’s owed to you in the form of a benefit. Let me ask you why you’re calling us? Oh, I have a toothache or I just moved in town or I have a wedding coming up and I need to… So switch the conversation to what made them pick up the phone and call you and build relationships. I remember, as a pet owner, one time our pet was bleeding and we didn’t know why. And the person answering the phone really empathized with us. They really put themselves in the shoes of us and talk to us as if they were standing next to us, watching over this pet and worried over this pet, right? They are no longer listening, they’re no longer paying attention, they are no longer into the conversation.

Naren Arulrajah: So switch the conversation to what made them pick up the phone and call you and build relationships.

Naren Arulrajah: That kind of empathy, that kind of focusing on the client, focusing on the patient, those are skills that have to be taught. And I think when you make a transition, nobody trains the team, nobody listens to calls. One of the biggest mistakes I see that practices fail is they’re not listening to calls. They don’t know what’s going on. They just assume everything is wonderful. But the problem is, customers change, the world changes, how people think changes. If nobody’s listening, nobody’s coaching on a regular basis, things tend to slip. And the average dental practice in the United States is only booking one out of three new patients. I give you one of those leaks, which is when the patient says, "Do you take X, Y, Z insurance?" The other leak is they ask about how much does it cost? The same question I ask my car dealer.

Naren Arulrajah: And immediately people go into, "Oh, it could cost 2,000, it could cost 3,000." You start doing things that you’re not capable of doing over the phone. So a lot of times, you turn people off. So you have to make them build a rapport, build a relationship, make them come in and talk to the doctor, see the practice, see what their options are, because a lot of times, for many issues, there’s no single option. There are multiple paths a person can take. The path that is comprehensive as an all-in, or a path that’s step-by-step, or, let’s stop the problem right now and then let’s think about how do we do the right thing in the long term? So there are lots of paths, right? Everybody has challenges just like, some have the money sitting in a bank account, $50,000, others don’t.

Naren Arulrajah: So how do you create a solution for them regardless of what their situation is, regardless of where they are, without judgment, without saying, "Oh, this is a good patient, that is a bad patient." A lot of times what I also see is the team starts believing what they do, so their conversion rate is 20%, but in their mind, the other 80% who we said no to or who we were not nice to, even our tone of voice or the way we spoke to them are wrong patients in the first place. But every human being in that case is the wrong patient. Everybody who has a need is the right patient. They’re calling your office, they’ve done the research, they have decided that you might be able to help them. Who are you to tell them that they’re the wrong patient? One of the biggest mistakes I see that practices fail is they’re not listening to calls.

Naren Arulrajah: Everybody who has a need is the right patient. They’re calling your office, they’ve done the research, they have decided that you might be able to help them. Who are you to tell them that they’re the wrong patient?

Naren Arulrajah: You have to meet them where they are, build a relationship, get them to come in, and then just one visit, then build a rapport, then make them fall in love with your practice and they realize why they need to come to your practice. So I do think the phone is the biggest gap that people have to fix, and I think I would start by recording the call so you know what’s going on. Of course, the phone call will say, "This call may be recorded for training purposes," so people know, you’re very upfront, you’re very straightforward. They know that the call is being recorded and they know what’s going on. And the other place I do think you wanna make sure you’re very consistent is even in the office, right?

Naren Arulrajah: Tell them how much something costs before you start treatment so there’s no surprises. That I think is even more important. You don’t wanna start the work and say, "Oh, you owe me $2,000," right? Before you start treatment, say, "Hey, this is what we can do. Here are the options, if you go this route, this is how much it’s gonna cost you. If you were to pay the whole thing right now, you will save 10% and here is an early payment fee reduction," however you wanna phrase it. So if they don’t have insurance, "Hey, as a member, this is our member price. Without membership, this is how you would pay," offer the membership, help them save that money. If they’re gonna spend $10,000 and your members save 10%, offer the membership.

Naren Arulrajah: I know you might be thinking, "Oh, we’ll make an extra $500, if you don’t offer the membership." But in the long term, that patient is gonna be loyal to you, that patient is gonna come back to you, and they’re gonna use that membership to continue to come back because the membership typically will come with two cleanings every year. So you build a relationship. So do what’s right for the patient, put the patient first. All of this requires training, coaching, paying attention to the details, and then knowing what’s going on. Tell them how much something costs before you start treatment so there’s no surprises.

Naren Arulrajah: But in the long term, that patient is gonna be loyal to you, that patient is gonna come back to you. So do what’s right for the patient, put the patient first.

Don Adeesha: So, Naren, if an owner wants to fix this starting next week, where should they start?

Naren Arulrajah: I do think the step one is to see if you’re attracting the right kind of patients, right? If you’re not attracting a lot of patients, like I mentioned at the start of the conversation, have the patients have no insurance. So are you attracting those patients? Are those patients calling your office? And today, how do patients find you? 95% of patients are gonna find you because of Google. Either you’re running Google Ads or you are doing organic marketing. The Google Ads, the challenge is it can be five to 10 times more expensive than organic marketing for two reasons. Google charges more and more and more over time, and it’s a bidding system. As long as somebody’s willing to pay more, you have to end up paying more. So that’s one reason why Google Ads are five to 10 times more expensive than organic search.

Naren Arulrajah: And the second reason is people don’t trust ads. They have this subconscious belief that doctors are different. They are MDs, meaning they became a doctor after training for 10 years, so they must be good. So when you run an ad as a doctor, they think there’s something wrong. So they come in with a negative mindset, like what’s wrong with the situation mindset. So even something tiny on your website might trigger them. They’re like, "Oh, you know what? I’m not really sure." They’re gonna leave. Or even after they book the appointment, something triggers them like, "Oh, I expected them, the doctor’s office, to do this, but they didn’t do that, so maybe it’s not a good office." So you will have a lot of no-shows, a lot of people not saying yes. Google charges more and more and more over time, and it’s a bidding system.

Naren Arulrajah: And the second reason is people don’t trust ads.

Naren Arulrajah: If your conversion rate, let’s say, is 60% for organic patients who didn’t see an ad, your conversion rate for ads patient would be 30%. They’re gonna not only spend a lot more money, but you’re gonna be losing a lot of money. So you have to ask your question, what are your options to attract new patients outside of PPO plans? It really is one, you become a celebrity on social media. They’re called influencers, you become famous, you have 10, 20, 30,000 followers. That’s option A. But my experience is less than 1% of you will post two videos a day and will stay with it to become a celebrity. You don’t enjoy being a celebrity. Most doctors I know are private people. They wanna do their own thing, live their own lives without sharing their whole life with the whole world two times a day. So the second option is, obviously, dominating organic search. If your conversion rate, let’s say, is 60% for organic patients who didn’t see an ad, your conversion rate for ads patient would be 30%.

Naren Arulrajah: Most doctors I know are private people.

Naren Arulrajah: That’s where we can help. So that today means AI search, ChatGPT, Perplexity, Google. Google still is the huge player in the whole space. So one thing I would recommend is we offer what we call a marketing strategy meeting. It’s a comprehensive review. We look at you, we look at your competition, and we’ll tell you how well or how poor you are doing so you can do something to change it. So the meeting link is lessinsurancedependence.com/msm . We’ll tell you where you are getting an A, where you’re getting a B or a C or a D. And that way you know where you stand on the different keys to success. And once you know where you stand on the different keys to success, we’ll also give you a plan on how to get to an A within 12 months, how to dominate, how to have an unfair advantage when people with insurance and without insurance are finding you for all the things they need, whether it’s implants, whether it’s Invisalign, whatever that you specialize in, or whether it’s just emergency or everyday general dentistry.

Naren Arulrajah: Once again, the link is lessinsurancedependence.com/msm .

Don Adeesha: Amazing. Thank you very much, Naren Arulrajah. That was Naren Arulrajah on answering the insurance question before the first visit. If you’d like a second pair of eyes on what your website says about insurance and cost, Naren’s team does that in a free marketing strategy meeting. The link’s in the show note as well. I’m Don Disha, and this has been the Less Insurance Dependence Podcast. Thanks for listening. Keep on leading. So one thing I would recommend is we offer what we call a marketing strategy meeting. It’s a comprehensive review. We look at you, we look at your competition, and we’ll tell you how well or how poor you are doing so you can do something to change it. Once again, the link is lessinsurancedependence.com/msm