July 07, 2023 • 15 mins read

Patients Need to Be Seen: Financial Roadblocks Facing Patient Care in Dentistry.

Dental professionals aim to provide the best care for patients, but financial barriers can hinder treatment. Billing medical insurance can help patients and practices.



Danielle Duncan

Jaws, Ignored by Most Dental Insurance

As dental professionals, we are committed to providing the best possible care for our patients. However, financial roadblocks can often hinder patients from receiving the treatment they need. This is especially true in dentistry, where many procedures can be quite expensive. Fortunately, there is a solution that can help both patients and dental practices alike: billing medical insurance.

Addressing Financial Roadblocks in Dentistry the Old Way

Efforts to mitigate financial roadblocks in dentistry have always been crucial for improving patient care. Dental practices have already been working to follow several old-school strategies to limit patient financial burden.

Flexible Payment Options

Offering flexible payment plans or financing options that help patients manage the cost of treatment. This option allows individuals to receive the care they need without incurring a significant financial burden all at once. However, the drawback is, the full amount is still a cost burden to patients who are then stuck with monthly payments on an amount they may not be able to afford. 

Dental Membership Plans

Creating in-house dental membership plans can provide patients with affordable preventive care and discounts on treatments. Dental membership plans are usually based on a per-patient per month plan fee. 

This can be particularly beneficial for individuals without dental insurance or those with inadequate coverage. Remember, a practice’s goal is to put their patient first. Cost without insurance can sometimes be a deterrent to patients accepting care, meaning, some of these membership plans can come at a cost, leading to patient refusal of treatment if the amount of the treatment isn’t something they can afford, even with a membership plan. 

Collaboration with Dental Insurance Providers

Dental practices already collaborate with dental insurance providers to negotiate better coverage options for their patients. By advocating for comprehensive dental benefits, practices can help ensure that patients have access to the necessary treatments without undue financial strain. However, there are some limits in what can and cannot be negotiated with dental insurance and relies heavily on what the patient’s dental insurance will cover. 

The costs of dental care can be a significant burden for many patients, particularly those who require more extensive treatment. According to a survey conducted by the American Dental Association (ADA), cost is one of the most significant barriers to receiving dental care. In fact, more than one-third of adults in the United States have delayed or avoided dental care due to cost concerns.

For patients who require more complex procedures, such as oral surgery or orthodontics, the costs can be even higher. These procedures can easily cost thousands of dollars, and many patients simply cannot afford them. As a result, they may delay or forego treatment altogether, which can lead to more significant dental problems down the road.

However, by adding to the traditional methods of reducing patient burden by billing medical insurance, dental practices can help alleviate more of these financial burdens for patients. 

Medical insurance often covers certain dental procedures, particularly those that are deemed medically necessary. This includes procedures such as oral surgeries to treat sleep apnea, jaw surgeries to correct bite problems, and certain treatments for gum disease. That doesn’t mean you can’t get medical insurance to cover more mundane treatments. If you can prove medical necessity, it can be billed to medical insurance. 

By billing medical insurance for these procedures, dental practices can help reduce the out-of-pocket costs for patients. This can make it more likely that patients will seek out and receive the care they need, which can ultimately lead to better oral health outcomes.

Financial Roadblocks Facing Patient
The Importance of Medical Insurance in Dentistry

Financial Accessibility:

By billing medical insurance, dental practices can make the cost per visit more financially accessible for patients. Many individuals face economic constraints when it comes to dental care, but with insurance coverage, they can access the necessary treatments without worrying about exorbitant out-of-pocket expenses.

Expanded Treatment Options:

Medical insurance coverage allows patients to explore a wider range of treatment options. With the financial support provided by insurance, individuals can consider more extensive and advanced dental procedures that may otherwise be financially out of reach.

How Does Billing Medical Insurance Work?

When a patient seeks dental treatment, the dental practice can submit a claim to the patient’s medical insurance provider. This claim includes detailed information about the treatment provided, such as the diagnosis, procedures performed, why it is medically necessary, and associated costs.

Upon receiving the claim, the insurance provider assesses the details and determines the coverage and benefits applicable to the patient’s policy. The insurance provider then reimburses the dental practice directly, reducing the patient’s financial responsibility.

The Benefits for Patients

Cost Reduction:

By billing medical insurance, patients can significantly reduce their out-of-pocket expenses. This cost reduction ensures that individuals can receive necessary dental treatments without the burden of excessive financial obligations.

Enhanced Affordability:

Insurance coverage improves affordability by spreading the cost of treatment over a longer period. Patients can opt for payment plans or installment options, making dental care more manageable within their budget.

Access to Comprehensive Care:

Medical insurance often covers a broad spectrum of dental procedures, including preventive, restorative, and even cosmetic treatments. This allows patients to access comprehensive care that caters to their specific oral health needs.

How Does Billing Medical Insurance Help Dental Practices? 

In addition to benefiting patients, billing medical insurance can also be beneficial for dental practices themselves. By expanding the types of services they offer and the insurance plans they accept, dental practices can attract more patients and increase their revenue. This can help offset the costs of expensive equipment and technology, as well as other overhead expenses.

However, it is important to note that billing medical insurance for dental procedures can be a complex process. Dental practices must ensure that they are following all of the necessary guidelines and regulations to avoid any potential legal or financial issues. It can also be challenging to navigate the different insurance plans and policies that may cover dental procedures.

Fortunately, there are resources available to help dental practices navigate the process of billing medical insurance for dental procedures. The Imagn Billing Team and our easy to use software are all amazing tools to help your dental practice implement medical billing. Not only do you have access to powerful software, our team can help you understand how to properly code and submit claims for reimbursement.

Remember, billing medical insurance for dental procedures can be a win-win solution for both patients and dental practices. By reducing the financial burdens for patients, dental practices can help ensure that more patients receive the care they need. And by expanding their services and insurance acceptance, dental practices can attract more patients and increase their revenue. By working together, we can help ensure that everyone has access to the dental care they need to maintain optimal oral health.

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