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755: Reframing the Conversation Around Our Orthodontic Goals – Dr. Rebecca Bockow

A beautiful smile is always the goal — but it’s not the only goal in orthodontics. To reframe the role of early intervention and how it can transform patients’ lives, Kirk Behrendt brings back Dr. Rebecca Bockow, instructor from Spear Education, to explain the benefits beyond straightening teeth. When you understand the potential of orthodontics, you can help more patients long term! To learn more and register for Dr. Bockow’s course, Healthy Growth - Healthy Faces, listen to Episode 755 of The Best Practices Show!

Learn More About Robyn:

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Episode Resources:

Main Takeaways:

  • Make sure your patient is the main focus, not their insurance.
  • Be aligned with your team about your relationship with insurance.
  • Your entire team must know the ins and outs of insurance, not just admin.
  • Level up your verbal skills. Be intentional with words when talking to patients.
  • Utilize technology wherever possible to save yourself time and increase accuracy.
  • There is a time and place for outsourcing. But try to keep certain processes in-house.


“Insurance does cause us frustration in teams, and it can be also very time-consuming. So, having alignment systems, knowledge around insurance, what we can do, what we can't do, in-network versus out-of-network, all of those things around those are really important. Whether you're contracted or not, having that alignment is really important.” (1:43—2:07) -Robyn

“Having a strategy around managing frustration is important to the practice in so many different ways. The overall practice health, understanding those things and having a strategy, the patient satisfaction for what we know and how we address patients when they come in, the operational efficiency — there is a lot of time and energy that is put into managing insurance and benefits. So, having a strategy around that is really important. And as with everything, this is also a team game. So, having that team development and confidence is really important to manage the frustration for your patients and for the team, as a whole.” (2:45—3:20) -Robyn

“It isn't just the business admin team that needs to understand insurance — it's your dental hygienist, it's your assistant, it's the dentist that needs to understand it. In order for us to have a seamless transition for the patients, for us to all answer questions correctly, and to really build that trust with patients, it's important that we all are on the same page with it.” (3:42—3:59) -Robyn

“Identify and discuss, what is your relationship with insurance? So, like I was alluding to, we make an assumption that the admin team needs to know it inside and out — which is true. There's also an element to the assistants and the hygienists really understanding it as well. So, are we in-network? Are we out-of-network? What does that even mean, so we can answer questions with patients and be able to understand how to effectively communicate that and communicate it correctly to the patients for them to understand what their benefits are.” (4:09—4:41) -Robyn

“If you're a dentist listening to this, you're thinking, ‘Okay. Well, I want to get rid of DenteMax, BCBS, and all these other things,’ so you've been telling your team that. And I guarantee you, you have one or two team members that are like, ‘Well, my mom is on that. I have a family member on that. Is this all about money?’ What you have to do is go slow enough with your team to help them understand the bigger picture, because if you don’t, they're going to think this is all about money, and you can't have that happen. You need them, ultimately, to lean into these conversations and strongly support the position of the practice. That's why this has got to be done right. Also, a big piece of this is that the insurance relationship your practice has with your patients really has to be very well-understood by everyone — even a new team member, for the most part, coming in in the first two months.” (5:25—6:22) -Kirk

“There isn't a right or wrong being in-network or out-of-network. It’s not right or wrong. It's based totally on practices. Each practice has a different reason for having that different relationship, so it is about identifying and understanding the why behind it. Why did we decide to stay with this one and we're not with this one? And when you say not with this one, patients can still come to see you. So, the out-of-network piece, and understanding what that means for patients, that there are out-of-network benefits, it doesn't mean people can't come — it means the relationship is different. And there are many reasons to stay with some and not with others, or to be fee-for-service. So, there's a lot to that, and with the team, to really understand — outside of the money piece — there are dynamics that really are impacting what decisions you make around that.” (6:24—7:11) -Robyn

“My heart goes out to team members because they haven't really been trained or developed in this area. So, if you don't participate . . . I'd say north of 95% of team members in the United States that work for a dental practice say, ‘We don't participate with that insurance,’ which screams, ‘No.’ So, you have to be clear to let people know, ‘You can still come here, absolutely.’ They ultimately have to be able to say yes, but then you have to be able to navigate around that and ask really good questions.” (7:19—7:50) -Kirk

“[Align] on communication. How do we communicate what our relationship is to patients? What are the words that we use? That is such an important piece to this and can really make or break that relationship with the patient. The communication, the consistency of it, the messaging throughout — we don't want to have surprises. These insurance communications are tied to money, which is really an emotional part to the practice and for patients. So, aligning on how we speak about it and how we answer questions throughout the team is a really important part to the trust that we have with patients and the relationships that we build with them.” (7:58—8:34) -Robyn

“Instead of “out-of-network”, I will often use “independent provider”. So, ‘We're an independent provider.’ Some of the questions that I get from team members will be like, ‘Well, I don't want to mislead the patient.’ And really, what I'm trying to do there is when patients who are out-of-network — and team members — I believe that most of them think that they cannot use their benefits there. So, by using “independent”, really, what I'm asking patients to do is listen to what's next. I want to change the verbiage so that they hear me differently and that they're open to what I have to say next.” (8:51—9:21) -Robyn

“I really encourage teams to eliminate “but”, “however”, and “unfortunately” from their language and replace it with “and”. I hear so often in practices, ‘Unfortunately, we're out-of-network with that insurance company.’ What does that tell a patient right away? That tells a patient right away that is a negative. Anything that follows “but”, “however”, and “unfortunately” is a negative. So, if you replace it with “and”, you speak it differently. The patient hears it differently and the conversation ultimately goes differently.” (9:26—9:54) -Robyn

“I would say to a patient, ‘We're an independent provider for that. Let me share with you what that means for you,’ instead of, ‘Unfortunately, we're an out-of-network provider, but you can still use your benefits here.’ That sentence sounds totally different than the first one, and patients are going to hear you differently.” (10:10—10:25) -Robyn

“You don't have to get this right all in one day. Sometimes, you’ve got to try with one patient at a time. I've been saying this a lot. You know how you could build a great practice? One patient at a time.” (11:04—11:13) -Kirk

“Team members need to understand the why behind what your decision is about your relationship with the different insurance companies. That why is where the confidence comes from, and patients hear the confidence in the words that you use.” (11:28—11:40) -Robyn

“Utilize technology to your advantage. I think of this in a couple of ways. The business team, I know, spends a tremendous amount of time between verifying benefits, sending out insurance claims, following up on claims that weren't paid, all of those different things. So, where you can utilize technology to save yourself time and be more accurate with patients is a really important step.” (12:33—12:57) -Robyn

“How are you attaching X-rays, perio charting, and those kinds of things and sending out your claims? I find that there are services that are outside of your practice management software that are more cost-effective, in a lot of ways, and sometimes more user-friendly than your practice management software could be. So, it's worth looking into what that looks like and what services they offer. I find that insurance verification is becoming more and more user-friendly, and more and more companies are getting on board with it. So, there's a lot more information at your fingertips in terms of verification. And I talk with business team members all the time, and the amount of time that they are spending — I cannot underestimate how much time they are spending and how looking into technology could be a huge time-saver for your practice.” (13:13—14:07) -Robyn

“There is an alignment piece around that too, in verification. How many times are you verifying? What information are you verifying? Do you use all of it? If you're spending 10 or 15 minutes to get information, and then the patient is coming in again to see their hygienist and you're re-verifying, what information are you looking for? So, understanding the why behind that and whittling down to what you're really wanting to find out from insurance companies could also save a big amount of time.” (14:23—14:48) -Robyn

“I can see where there are benefits to [outsourcing certain processes]. I would do my best to keep it in-house for a couple of reasons. When you look at outsourcing, the cost that's associated with it, there are some great things that come from it. And it's not a negative towards outsourcing. It's more so they don't have skin in the game to manage your AR in the past two claims like your team does, and when they have a relationship with the patient. So, I like to keep it in-house. I think the AR and the claims-processing piece is such a huge part of the practice. I want to have more of my thumb on that to know exactly what's happening and making sure that it is done efficiently, patients are getting communicated with, those kinds of things. So, there's definitely a place for it. If you can keep it in-house, that is always my first recommendation.” (14:55—15:46) -Robyn

“There's so little training and development on these aspects in dentistry. And we joke — but it's not a joke — you don't really onboard team members. You just waterboard them and let them figure it out for themselves. That's not fair either. Then, you get frustrated that they're not doing it right. Well, they weren't onboarded. So, here's a great process that you can follow that Robin has given us.” (17:07—17:32) -Kirk

“Align with your team. Spend time in a meeting to have your team understand the why. It's really important, and it's going to show in the way that they communicate with your patients.” (17:34—17:44) -Robyn

“Remove the word “insurance”. You and I have said insurance many, many times today, and I believe that substituting with “benefits” is a better way to have that language with patients. It really is not insurance. It's more of a benefit plan. So, using that would be another verbal skills tip that I would put in there when you're speaking to patients. Ultimately, we want to make sure that our patient is the main focus, not their insurance. The insurance is a benefit. So, we want to maximize the benefits and do everything that we can to make dentistry affordable to them. Ultimately, it's about the patient and what's most important to them.” (17:50—18:24) -Robyn

“I really feel like there was a dental insurance executive — he's giggling somewhere in a room right now, going, ‘I can't believe they went for that! We called it dental insurance, and they all followed us.’ It has nothing to do with insurance. And so, you can't fix that. But as a dental team, you can start to change how you communicate. So, I love that, moving it away from [saying] “insurance” to “benefits”.” (18:34—18:58) -Kirk

“Thirty years of doing this, I've seen some of our best offices move away from the word “insurance” — or even “benefits” — and focus on the patient, and slowly and carefully, by osmosis or whatever, the practice ultimately becomes less insurance-dependent because you started becoming less insurance-focused or benefits-focused.” (19:01—19:24) -Kirk

“What we focus on expands. So, the more that we speak about insurance or benefits, the more a patient believes that that's what the focus is. Words matter.” (19:27—19:39) -Robyn


0:00 Introduction.

1:37 Why this is an important topic.

3:25 Set aside time to align with your team.

4:01 Define your relationship with insurance.

7:12 Align on communication to develop trust with patients.

8:35 Develop your verbal skills.

9:23 Eliminate “but”, “however”, and “unfortunately”.

12:29 Utilize technology to your advantage.

14:49 Should you outsource certain processes?

17:32 Final thoughts.

Robyn Theisen Bio:

Robyn Theisen brings an entire life and legacy of dental experience to the team and every team with which she works as the daughter and sister of dentists. With almost 20 years of experience in dentistry, her roles ranged from practice management to operations at Patterson Dental to coaching teams. Robyn’s passion is empowering teams to realize that they can dramatically impact the lives of the people they serve by implementing skills and systems to remove barriers to life-changing dental treatment. She has done it for decades and does it every day with dental teams.

Outside of coaching, she enjoys time with her husband, Rob, and two daughters, Emerson and Ruby. She loves traveling, music, fitness, and cheering on the Michigan State Spartans.