Should We 'Warn' Patients That We're Out Of Network?
Basically you want to know 'Should We Send Patients a 'We’re Not in the Cool Kids Club' Memo About Our Out-of-Network Status?'
The way we talk about insurance over the phone can make or break our new patient flow. Case in point: A practice was struggling with a significant drop in new patients. The front office star, Toni, asked me to review her calls to see what was going wrong.
And there it was—every single time a new patient called, one of the first questions Toni asked was, “Do you have insurance?”
If the patient answered “Yes, Delta,” she hit them with, “We are not Delta providers, but we can see you. However, you will be asked to pay at the time of service, since Delta won’t send the check to us.”
Cue the dial tone. 📞❌
Instead of rolling out the red carpet, Toni was putting up a giant “STOP” sign before the patient even made it through the door. When I suggested waiting until the patient brought up insurance, she resisted.
Toni: “I tried that last year, and a few patients got mad when they found out we weren’t in-network.”
Me: “How many patients exactly?”
Toni: “Uh… two?”
Let’s get real here: Two upset patients do not justify turning away hundreds.
The Fix: Flip the Script
The whole point of going out-of-network is to provide top-tier care without the constraints of insurance companies. But Toni’s defensive tone made it sound like we were running a shady back-alley practice. Even worse, she admitted, “If I had Delta, I’d go somewhere else too!” 🤦♀️
Here’s the new game plan:
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Stop assuming what patients value. Just because Toni prioritizes in-network coverage doesn’t mean every patient does.
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Lead with value, not limitations. Instead of focusing on what we don’t take, highlight what we do—exceptional care, personalized treatment, and an insurance-friendly approach.
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Be prepared for objections. If a patient gets upset, Toni now responds with:
“Mrs. Smith, when you called, our focus was welcoming you and helping you achieve your dental goals. Many of our Delta patients stay with us because they value the quality of care and trust us to maximize their benefits. It’s really the best of both worlds—you can still use your insurance here, and because Dr. X is an independent provider, we can maintain the high standard of care you deserve.”
Boom. No apologies. No defensiveness. Just confidence.
Existing Patients: Handling the “You’re Not on My List” Panic
So you’ve officially broken up with Delta, MetLife, or Cigna. 🎉 But now you’re wondering: How do I tell my patients without causing a mass exodus?
Rule #1: DO NOT send a letter announcing that you’re dropping their insurance. 🚫📬
Nothing makes patients panic faster than an official-looking letter that screams: “Find a new dentist!”
Instead, use face-to-face conversations to reassure patients. The PPO will send a scary letter telling them to switch providers. You need to get ahead of that so that YOU are controlling the narrative - not the insurance company.
What to Say (Without Sounding Like a Used-Car Salesman)
For patients in-office before the switch:
“At your next visit, you’ll notice our relationship with your dental plan will be slightly different. Dr. Brady asked me to share this note with you today so we can answer any questions.”
If they want more details:
“The great news is that since your plan is a PPO, you can go anywhere you choose. We’ve helped many patients maximize their benefits, and most find the fee difference is small compared to the quality of care they receive.”
For patients who won’t be in before the change: 📞 Call them. Don’t leave this up to a letter. Keep it casual and confident.
FAQs Patients Will Ask (And How to Answer Like a Pro)
❓ “Why are you not on my list anymore?”
➡️ “Because the insurance company’s restrictions impact the time and quality of care we provide. We believe you deserve better!”
❓ “Will I have to pay more?”
➡️ “It depends on your employer’s plan, but most patients find the difference is small—and we’ll still help you maximize your benefits.”
❓ “Do you take my insurance?” (From new callers) ➡️ Best response:
“We have a lot of patients with your plan. We’ll help you maximize your benefits and handle all the paperwork for you!”
Moral of the Story: 💡 Use the phone to welcome patients, not screen them out. 💡 Never say, ‘We are not a provider.’ Instead, say, ‘We are an independent provider.’ 💡 Assume people WANT to be in your practice—and most of the time, you’ll be right.
🚀 Go make it happen!