Should dentists help patients get more from their health fund cover?

health fund cover

While communicating effectively with patients can help retain them as customers, there are some curve balls to consider when talking to them about health-fund cover.
By Rachel Smith

For many dentists, the knowledge of health funds might be nothing more than a sticker you’ve put on your practice window to show you’re a preferred supplier. But should you be talking to patients about their cover? Should you be helping them make better use of their plans? What about advising customers or encouraging them to switch providers? If you think all that sounds like a minefield, you’d be right.

Of course, many in the dental industry believe dentists should let patients handle their own policies. Dr David Curnow, Vice Chair of the Australian Dental Association’s Schedule and Third Party Committee, is one of them. “Your overriding issue is to do the best treatment for the patient’s oral health,” he says. “There are some exceptions where the dentist is a contract provider, but if the dentist is not a contract provider, the relationship between the health fund is between the fund and the patient and doesn’t really have much to do with the dentist.”

Health insurer Bupa agrees that it’s up to the patient to investigate possible rebates. “But what customers want to know and we’re advocating for across all health services, is transparency in fees. Customers should know, where possible and in advance, what a treatment is likely to cost,” explains James Howe, Bupa’s media and corporate communications manager. “Then, patients can contact us before making a booking to confirm what they can claim.”

But what if you’re faced with patients confused about health cover or are paying for things they don’t need? Research by independent news site The Conversation found that people with private health cover often have ‘limited awareness’ of what’s covered in their policies. Adelaide dentist Peter Aldritt—who’s been in general practice for 25 years—says it’s something he sees all the time and is one reason why he talks to patients more about private insurance than he used to.

“I think a lot of people have had the same policy for years and they’ve never really investigated it.”—Dr Peter Aldritt, Adelaide-based dentist

“I think a lot of people have had the same policy for years and they’ve never really investigated it and seen what they’re actually insured for,” he says. “And, now they’re older, their needs have changed and what they’re insured for is no longer appropriate.”

Why you should talk policies with patients

Health insurance companies are invading the relationship with patients a little more than they used to, says Dr Alldritt, so dentists may feel it’s their responsibility to speak up. “Health funds have their own clinics and are trying to attract their customers who may actually be my patients. So I feel it’s my responsibility to start talking about it, because I have to protect my own business at the end of the day.

Dr Alldritt’s practice is behind the Time To Switch campaign launched by the ADA and says he encourages patients to investigate their health fund, consider whether it’s appropriate or even the right fund for them. “Are they being insured for things that they need? Are they being insured for orthodontics when they’re not going to have orthodontics? Or they haven’t got kids, or their kids are grown up? Their kids aren’t going to have braces now, are they? People need to look how beneficial their insurance is, and whether they’d even be better off dropping extras and just paying for your own dentistry, and optometry, and physio. Because while private health insurance premiums are going up a lot every year, it appears to us that the amount of rebate patients get is not keeping up with that.”

He adds that his practice is very open with their patients in declaring that they’re not preferred providers to anyone. “We’re completely independent and we treat our patients the same no matter who they’re insured with, or whether they’re insured at all,” he says. “It’s not going to affect our decision making when it comes to the patient’s dental health and people seem to really click with that.”

Health funds and customer retention

From a marketing standpoint, should you be communicating about health fund rebates and whether you’re a preferred supplier to patients? Dental marketing expert Carolyn Dean says yes—especially when you consider attracting new patients will cost your company five times more than retaining existing ones.

“I find that so many dentists have things they can do to communicate with their patients but they just don’t educate or remind them.”—Caroline S. Dean, marketing consultant, My Dental Marketing

“Dentists don’t actually communicate with their patients. If the dentist is say, a BUPA or NIB preferred provider, are they talking about it? Do they have signs up in their waiting room? Do they have flyers? Are they including a mention on their recalls or on their website? Across the board I find that so many dentists have things they can do to communicate with their patients but they just don’t educate or remind them. Even just simple things like letting patients know it’s end of calendar year and they need to use or lose their health fund benefit is critical,” explains Dean.

“You can take the passive view, which is ‘Well, the patient should know about [their cover] and they should be the ones that are calling’, but the dentists who do that are going to be losing their patients,” she says, “because there will be other dentists out there saying, ‘Okay, I need to take control. I need to be communicating with my existing patients. I need to tell them this, or tell them that they need to come back in. You need a plan, you need to know what channels you’re communicating to your patients on, and you need to get in there and do it.”

That said, she warns that dentists should be aware of the regulations and what they can and can’t do when advertising or mentioning things like health cover. “You can be in breach of regulations and get a fine, which is why we suggest outsourcing your marketing strategy to those who know the industry and the guidelines well.”

Dr Curnow also urges dentists to be wary. “You wouldn’t want to be seen to be encouraging treatment just to use up a perceived entitlement to some sort of health fund rebate—that would be contravening your ethical duties.”

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