Why changing your words may be more profitable than changing your dental insurance contracts

Doctor, let’s say you diagnose three crowns. You know clinically your patient’s teeth should be protected. You let them know exactly what’s happening in their mouth and what you suggest, but before you get into timing or financial options, your patient asks what you tend to hear all the time: “What will my insurance cover?” Or worse, “As long as my insurance covers it.”

So often, the response from either you or someone on your team goes something like, “You have enough insurance remaining to cover one crown this year. We can do another next year when your benefits renew.”

Just like that, your treatment plan has been reorganized around an annual insurance “benefit.” Your diagnosis remains the same, as does the condition of your patient’s teeth, but the language may have altered the patient’s decision. 

Jodi Boni.

You know what’s going to happen. The patient will be entirely focused on what their insurance dictates, but if they only do one tooth at a time, a tooth that needs a crown today becomes a root canal and a crown in a few months.

What initially sounds like a “financially responsible” way to help the patient may ultimately result in more extensive treatment at a greater expense down the line.

Conversations around insurance happen all the time in dental, and each dental team has learned ways to work within the parameters set by insurance plans, which have now become the loudest voice in the room.

So how do we change it?

One word can change the entire conversation

I hate the word “covers.” It’s one of the first words I encourage dental teams to replace. When someone says, “Your insurance covers 80% …” the patient hears a certainty. “Covered” sounds like it’s all taken care of. But benefit information is generally an estimate, and the insurance company will make its final determination after the claim is submitted.

So instead of saying “covers,” try saying something like, “Based on the information available to us, your insurance’s estimated contribution is approximately 80%.”

Saying “contribution” creates a more accurate expectation. The benefit can help the patient pay for care while the clinical recommendation remains grounded in what the patient needs.

The same principle applies throughout your practice. Here are some other examples of how what we say impacts how patients view the care they receive:

• Calling a preventive visit a “free cleaning” unintentionally strips value from the appointment.
   
• Referring to perio therapy as a “deep cleaning” can lead patients to confuse a therapeutic procedure with routine preventive care.
   
• Telling a patient you are “waiting for insurance approval” unintentionally gives the insurance carrier authority over a clinical decision the doctor has already made.

Phrases like these are familiar because dental teams have used them for years, and they shape how your patients understand the value and necessity of care. Psychologists call this the framing effect: The way in which information is presented can influence how people interpret it and the decisions they make. In one randomized medical study, participants presented with the same treatment information made significantly different treatment choices depending on how that information was framed.

Clearer language gives patients a more accurate picture of the care being recommended and helps them understand its purpose, value, and clinical importance. 

Help patients understand the need first

Insurance discussions should always come later in the treatment conversation. Before discussing benefits, give your patients the opportunity to really understand what’s happening in their mouths and why treatment is being recommended.

Patients are more likely to move forward when they understand what’s happening in their mouth and participate in the conversation, so show them intraoral photos. Walk them through x-rays. Explain all the risk factors contributing to their condition. Ask questions. Let the patient ask questions. Keep their interest without any judgment. Connect the doctor’s diagnosis to their overall health, habits, and concerns.

When the patient understands what’s going on, your team can begin discussing financial resources, timing, and then estimated insurance contributions. Some patients might want to complete treatment all at once. Others might need to phase care. You can help them explore workable options while filing with the insurance company to seek the maximum reimbursement available. That sequence keeps the clinical recommendation in full view.

Speak the same language

A patient might ask the doctor about insurance, then they might repeat the same question to the assistant, and then later bring it up at the front desk. When every team member answers differently, confusion sets in.

I once coached a practice that was receiving frequent insurance denials for crowns on teeth with visible cracks. Patients were frustrated because they expected their plans to “cover” the procedures, but that obviously wasn’t happening. 

So we changed the conversation.

The doctor remained focused on the clinical problem: what he could see, why he was recommending a crown, and what he hoped to prevent. His administrative team prepared patients for the possibility that their plans might contribute little or nothing and that the practice would still submit the claim on their behalf.

Patients then entered the financial conversation with a clearer understanding of why the treatment was being recommended (and why it was important), and they had a more accurate expectation of the role their insurance played. 

It took a lot of practice and training for the practice to be consistent with this strategy, but once they got it, patients were happier, and they began choosing the right course of action no matter what their insurance did or didn’t contribute.

Listen to the language your team uses

The language we use daily becomes a habit, and after a while, we stop hearing the patterns we use to move patients through their visit. Patients, however, hear what we say, learn from it, and respond to their care through the language we’ve given them.

If your team consistently talks about what insurance “covers,” patients will naturally start making decisions based on what insurance covers. If we call something a “free cleaning,” we’ve already told the patient how much value to place on that visit. When we say we’re awaiting “insurance approval,” we’ve given the insurance company a much larger role in the conversation than it deserves.

This is why when I’m coaching dental teams, I spend time listening to how each team communicates.

Sometimes a practice knows patients aren’t moving forward with treatment, but the team can’t see where the disconnect is happening. It could be how the doctor explains the diagnosis, or it could be during the hand off. It could even stem from a single phrase someone on the admin team says without thinking about the impact of those words.

This is why coaching is valuable. Someone from outside your practice can hear those things much more easily and help the team create a consistent way of talking about treatment, value, and insurance. 

When patients hear clearer language, they start to think of their care differently, and they can make better decisions based on what they need with a clearer picture of how their insurance benefits fit into it.

The language your team uses teaches patients how to understand their care. Choose your words carefully, and you can change far more than the conversation.

Consider these simple shifts in verbiage 

Consider the difference between “Your insurance covers 80%,” and “Based on the information available to us, your insurance’s estimated contribution is approximately 80%.”

And instead of “Can I confirm your free cleaning for Thursday at 2 p.m.?” try “We have 2 p.m. on Thursday reserved for your preventive care visit with Mary.”

The objective is to use language that accurately reflects the value, purpose, and clinical importance of the care being provided. When the language changes, the conversation changes. And when the conversation changes, patient behavior can change with it.

Editor's note: References available upon request.

Jodi Boni is a team development coach with Productive Dentist Academy. She has 20 years of experience in the dental industry, with a background spanning clinical care, practice management, multisite operations, and team development. Boni specializes in helping dental practices improve their operations, strengthen patient communication and case acceptance, and implement systems and technology that support sustainable growth.

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