How to Handle Insurance Questions When You’re Out of Network

Navigating insurance questions can be challenging — especially when your dental practice is out of network for a potential patient’s insurance. However, every potential patient is an opportunity. You might be surprised — with the right approach and effective communication, you can convert these inquiries into appointments. Follow these proven tips and tricks to address insurance questions confidently, book more appointments, and build a more profitable dental practice.

What Not to Do

How many times have you heard a potential patient ask if a dental office takes their insurance, only to hear a team member respond:

“No, sorry, we don’t.”

Or, even worse—


…with zero follow-up or attempt to book the appointment regardless.

These are huge missed opportunities! The reality is that by clearly communicating your practice’s value, your willingness to file claims on their behalf, the potential drawbacks of their insurance coverage, and, if applicable, an in-house dental plan, you can convert many of these callers into appointments.

Let’s look at some effective communication strategies to do just that.

Effective Communication Strategies

Emphasize the Value of Your Services

When discussing insurance with potential patients, it’s essential to emphasize the value and quality of your dental services. Highlight your expertise, the advanced technology you use, and the positive experiences of your existing patients.

Don’t Just Say “We Don’t Accept Your Insurance”

Frame your response more positively. Instead of rejecting a potential patient outright, say something like “We accept all insurance. While we’re out-of-network with your insurance, we’ll file your insurance claim for you, saving you the hassle of all the paperwork. We’ll also help you maximize your benefits.”

Explain Insurance Benefits Clearly

Clear and transparent communication about insurance benefits is crucial. Help patients understand how their insurance works, what their out-of-pocket costs might be, and how your practice can help them maximize their benefits.

Explain Why Your Practice is Out of Network

Potential patients might not understand that your decision to be out-of-network can actually benefit them, as well. In most cases, fee-for-service practices are able to provide higher-quality care, simply because they have better control over the procedures they offer, the time they can spend on treatment, and the materials they use. Explain this to patients — in many cases, they may opt to pay a higher cost for the better service you’re able to provide.

Break Down the Costs

Provide a clear breakdown of potential costs, including estimates for treatments, what their insurance might cover, and what their out-of-pocket expenses could be. Transparency helps build trust and reduces anxiety about unexpected costs. In many cases, detailed cost breakdowns reveal that out-of-network practices’ services are surprisingly affordable in comparison to insurance plans, which frequently cap benefits or cover only a fraction of treatment.

Offer to Assist with Insurance Claims

As mentioned above, assure patients that your practice will assist them with submitting insurance claims and maximizing their out-of-network benefits. This level of support can be a deciding factor for many patients.

Offer an In-House Dental Plan

In-house dental plans are a fantastic alternative for patients concerned about out-of-network costs. These plans can provide affordable care options and help convert potential patients into regular visitors. Add a qualifying sentence every time you say, “We’re not in network with your insurance, however, we do offer an in-house dental plan…” If the potential patient is still on the fence, offer to text or email additional information for them to consider. 

What Are In-House Dental Plans?

In-house dental plans are membership programs offered directly by your practice. Patients pay an annual or monthly fee in exchange for access to certain dental services at reduced rates. In many cases, practices will offer additional discounts on services beyond what’s included in the base plan. 

Benefits of In-House Dental Plans

  1. Cost Savings: Patients can save money on treatments compared to paying out-of-pocket.
  2. Predictable Expenses: With set fees, patients know exactly what to expect.
  3. No Insurance Hassles: Patients don’t have to worry about insurance claim processes and denials.
  4. Enhanced Loyalty: These plans can help build long-term relationships with patients.

Converting Inquiries to Appointments

Hopefully, it’s apparent by now: every insurance inquiry is an opportunity to convert a potential patient into a loyal one. Here are some strategies to help you achieve this:

Offer a Free Initial Consultation

Offering a free initial consultation can help alleviate concerns about out-of-pocket costs. This approach allows patients to experience your practice firsthand and understand the value you provide.

Offer a Free or Reduced Fee Service Upfront

Beyond a simple consultation, you might also consider offering a free or reduced fee service upfront. A “new patient special” — perhaps an exam and x-rays — for $99 can help introduce new patients to your practice and offset initial cost anxiety. 

Consider a Free iTero Scan

Does your practice have an iTero scanner? Offering a free scan and consultation is a great way to introduce your practice, highlight your advanced technology, and identify potential opportunities for treatment. Patients who have never experienced this kind of technology are often inclined to tell their friends, as well. 

In our experience at DentalScapes, this is one of the most effective initial offers we’ve seen dental practices implement.

Provide Flexible Payment Options

Providing flexible payment options, such as payment plans or financing (e.g., CareCredit or Cherry), can make your services more accessible when you don’t accept insurance. Make sure potential patients know about these options when discussing costs and insurance.

Training Your Front Desk Team

Of course, a plan is only as good as the follow-through. To convert more patients when you don’t accept their insurance, make sure your dental practice implements the following:

Front Desk Training

In most cases, your front desk team is the first point of contact for potential patients. Proper training ensures they handle insurance questions effectively and convert inquiries into appointments. Whether you provide video training, virtual consultations, or in-person coaching, front desk and call handling training is a must for dental practices looking to convert more inquiries into fee-for-service patients. At DentalScapes, we’re proud to provide every client with on-demand video training, monitor call recordings, and opportunities for virtual and in-person front desk coaching when needed.

Provide Clear Information

Ensure your front desk team is well-versed in your practice’s policies, insurance details, and in-house dental plans. They should be able to provide clear and accurate information to potential patients. To keep everyone on the same page, consider providing quarterly “lunch and learns” where you can share the most up-to-date information, answer questions, and even role-play common scenarios. 

Building Rapport

Training your team to build rapport with callers is crucial. Friendly, empathetic interactions can make a significant difference in a patient’s decision to book an appointment. Always answer phone calls with a smile — it can actually make a difference in your tone of voice! 

Handling Objections

Equip your team with strategies to handle common objections. This includes addressing concerns about costs, insurance coverage, and the benefits of choosing your practice despite being out of network. And remember, even though every phone call is an opportunity, that doesn’t mean that every potential patient will ultimately be a good fit. Address objections with respect and transparency, but be ready to bring the conversation to a polite close if you’re not making any headway.

Transform Challenges into Opportunities

Handling insurance questions when you’re out of network doesn’t have to be a buzzkill — and actually presents an opportunity for your practice to demonstrate value and book more appointments. 

At DentalScapes, we specialize in managing online marketing for dental practices and provide front-desk call-handling training as a part of every marketing program. We monitor call handling and frequently consult with clients on strategies to convert more calls into appointments. Book a free strategy call today and let’s explore the possibilities.