Real time, real world data to run your practice

Production Doesn’t Tell the Real Story

Do your staff see your production and think everything is great? And, since they see solid production – do they expect to receive a raise this year and maybe even a bonus?Mission-77,-LLC-How-to-Set-Up-Dental-Insurance-Plans-in-Dentrix-cover - Copy

Meanwhile, are you looking at your lower and lower reimbursements now that you’ve been forced to join a variety of dental insurance plans? If your local economy has suffered large employer closures and now there are many unemployed or underemployed families in town, you may also have joined Medicaid.

The Challenge of Managing Multiple Dental Insurance Plans

On top of the reduced collections, you may be realizing what a challenge it is now to manage your dental practice. When you have a stable of insurance plans you’ve joined, you have to make sure that you are looking at the right numbers. If you just look at your production, you will be misled – just like the staff. So, you know you have to look at collections, but you have to figure out how to manage these dental insurance plans so you have “real time, real world data” (love this phrase! borrowed from a dentist in Louisiana via email recently – Thanks Dr.!).

When you join several insurance plans, here are the things you need to know:

  • Fee schedule – how to enter the negotiated fees into your system
  • Subscribers in your zip code(s) – so you know how many potential new patients you could gain by joining
  • Number of existing patients with this insurance plan – once you join, these folks suddenly change from out-of-network to in-network and you need to recognize the effect this will have on your collections
  • How to set up the plan properly in your dental practice management software – to make sure you submit your full fee to the insurance plan, but enter the negotiated fee into the patient’s ledger
  • How to enter insurance payments so your computer system improves its insurance estimates in the future
  • How to compare the different PPO plans so you know which are the best and worst – so that you can answer the question of patients “Which insurance plan should I join?”
  • How to train your staff to add patients with this employer and insurance plan

The Setup is the Key

You can make your life much easier by setting up each insurance plan properly. Entering the fee schedule properly and identifying the correct claim format will save your office staff mountains of time because the negotiated fee will be entered on the patient ledger. That saves your office manager from manually entering an insurance adjustment on every patient, or even every code! Also, by setting up the proper tracking for the insurance plans, you will be able to run reports that give you the information you need to evaluate each PPO plan’s performance. 

For Dentrix users, I have written step-by-step instructions on how to set up your dental insurance plans. Although I am not a certified Dentrix trainer, I have used this approach to manage the 6 different PPO plans in my group practice. The setup I use has allowed me to provide the real time, real world data our dentists needed to make decisions about dental insurance. To learn more about these instructions, visit

Setting up dental insurance plans is just one way to run a successful dental practice. If you’re interested in new ideas on running a dental practice, please subscribe to my weekly blog. One of the biggest challenges to managing a dental practice is managing dental insurance. With dental insurance handled, then dental marketing for new patients becomes a primary focus. In today’s day of online reviews, handling patient complaints well is essential. As your practice grows, hiring dental staff becomes more important. With 16+ years of dental practice management experience, I’m open to your questions to help you run a successful dental office.

Feel free to email me.

AUTHOR: Jill Nesbitt
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