An Early Bite with Dr. John Paul: “Are You on My Insurance?”

By Dr. John Paul, FDA Editor

What do you want your staff to say when a patient asks some variation of, “Why aren’t you on my insurance plan?” This is usually asked with the hidden threat or just basic confusion that they have to go where their insurance says.

“Mrs. Gruntbuns, if Dr. Paul were to be ‘on your insurance’ he will be required to sign a contract with your company that will dictate how he behaves when he sees you. Sometimes it may be just as simple as what to charge when, but it could mean he can’t provide a service that might be the most appropriate service for you. Because he believes no one should interfere in his relationship with you, he is unwilling to sign such a contract. That said, we will work with any insurance company that can provide your benefits in a timely manner without undue interference; we just aren’t ‘on your plan.’”

If you are a preferred provider for some plans but not all, you can use this same wording. Just note that you have reviewed the contract you will be required to sign and feel that unlike other plans you accept, this one will put unnecessary stress on your doctor-patient relationship.

Have a question you have a tough time answering? Send it to Dr. Paul at jpaul@bot.floridadental.org.

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