1072: Metric Mondays: When Insurance Drives the Conversation, Value Gets Lost - Carlie Einarson

When insurance drives patient conversations, treatment decisions can shift away from health needs and toward coverage limits. In this episode, Kirk Behrendt speaks with Carlie Einarson, dental practice coach, about changing the way teams discuss insurance, treatment, and patient value. You will learn how insurance-first language affects trust and profitability, which metrics reveal the financial impact of PPO participation, and how to lead with relationships and clinical recommendations instead of benefits.

To help patients choose your practice for the care you provide rather than your participation on an insurance list, listen to Episode 1072 of The Best Practices Show!

Main Takeaways:

• Insurance-centered conversations can cause patients to base treatment decisions on coverage rather than their health needs.
• Repeatedly mentioning insurance trains patients to view it as the primary decision-maker.
• PPO adjustments create an effort gap between a practice’s full fee and the amount it ultimately collects.
• Teams should explain the patient’s condition, recommended treatment, and value of care before discussing benefits.
• Insurance should be positioned as a benefit that may contribute toward treatment rather than determine treatment.
• Practices need to track their adjustment and write-off percentages before making informed decisions about PPO participation.
• Relationship-based conversations help patients choose a practice because they trust the team and the care it provides.

Snippets:

00:00 When insurance drives the conversation, value gets lost.

01:19 Introduction to Metric Mondays and Carlie Einarson.

02:32 Why insurance-centered conversations affect treatment decisions.

03:37 How practices unintentionally create insurance-focused patients.

04:15 Signs that insurance is driving conversations in the practice.

05:43 How PPO write-offs create an effort gap.

07:25 A relationship-based response to insurance questions.

09:07 What insurance conversations look like when a practice gets them right.

10:44 Track adjustments, write-offs, and the practice’s effort gap.

11:16 Why trust and value should guide patient decisions.

13:33 Questions teams can ask to evaluate insurance-focused language.

15:09 Create value before discussing price or benefits.

15:47 Share the episode with the team and discuss a different approach.

Guest Bio/Guest Resources:

Carlie Einarson is a lead practice coach who has a passion for helping others succeed in the dental field. She loves helping to create a stable foundation for practices so both professionals and patients have a great experience every time they walk in the door!

Carlie graduated from Utah College of Dental Hygiene. She has ten years of experience in the dental field, including clinical dental hygiene, front office, and leading teams.

In her free time, she enjoys spending quality time with loved ones, traveling, skiing, playing volleyball, and golfing.

More Helpful Links for a Better Practice & a Better Life:

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• Upcoming Events & Workshops: https://www.actdental.com/events/
• Smile Source: https://www.smilesource.com/
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