It is the second week of October. Hygiene is booked solid through November, the doctor’s schedule has gaps in December, and somewhere in the patient base there are a few hundred people with planned treatment and insurance money that disappears on 31 December.
Filling December is a matching exercise: patients who have benefits left, treatment planned, and no appointment. The data for all three is already in your software.
Who should be on the list?
Three conditions, all true:
- Remaining annual maximum above a threshold. $300 is a sensible floor; below that the call rarely pays.
- Treatment planned and not scheduled, or hygiene due and not scheduled.
- Plan year ends 31 December. Most do, but check: some employer plans renew mid-year, and calling them in October is a wasted call.
A worked example. 2,400 active patients. 1,650 have insurance. 410 of those have $300 or more remaining. 190 of the 410 have planned, unbooked treatment or an overdue recall. That is the list: 190 names, not 2,400. Each one gets a call and, if the call fails, a letter.
Average remaining benefit across the 190 is $820. Multiply: $155,800 of insurance money on the table, before patient shares. That is found, not recovered. Recovered is only the part that ends up booked, completed and paid in the practice software.
How do you find them in each system?
Open Dental. The Treatment Finder (Reports) can be filtered for planned treatment and shows each patient’s remaining annual maximum and the benefit year end. For hygiene, the Recall list. Insurance remaining lives on the family module’s insurance plan with the benefit year month set per plan.
Dentrix. Office Manager, Reports, Lists, Unscheduled Treatment Plans for the treatment side; the Insurance Maximums and Deductibles report, or the family file’s coverage table, for remaining benefits; Continuing Care for hygiene.
Eaglesoft. Money Finder is built for this: it lists patients with remaining benefits and planned treatment in one view. Set the benefit threshold and the date range and print it.
Clean-up first: patients whose insurance was never updated after a job change will show the old plan’s remaining maximum. The insurance coordinator’s eligibility checks in the insurance coordinator page are what keeps this list honest.
When do you start?
- Early October: build the list. Send the first letter or email to everyone on it.
- Mid October through November: calls, newest plans and largest benefits first. Hold December doctor time open rather than filling it with hygiene.
- 1 December: second notice to anyone not booked, with the date the benefits expire written out.
- Mid December: last calls. Anyone who cannot be seen in time gets a January appointment booked now, so the new benefits are used early rather than late.
What do you say?
“Hi, it’s Dana from Dr. Ellery’s office. I was checking your insurance and you have about $900 left on your plan this year, and it goes away on 31 December. Dr. Ellery had recommended a crown on the lower right; with your insurance that would be around $350 out of pocket if we do it this year. I have a Tuesday morning or a Thursday afternoon in the next two weeks. Which is easier?”
Use the patient’s real numbers. A letter version is on the unused benefits letter page, with three templates.
What goes wrong?
- Calling patients whose plan year is not the calendar year.
- Estimates that ignore the deductible, which may also reset.
- Filling December with prophies that could have gone in January, and leaving no room for the crowns.
- Not tracking the outcome, so nobody knows in February whether the effort worked. Count booked, completed and paid, separately.
What Calibic adds
The insurance benefits list is LIVE. Calibic reads insurance plans, remaining maximums, treatment plans and appointments from Open Dental, Dentrix and Eaglesoft (read-only, it never changes a record), applies the three conditions above every morning, and ranks the list by remaining benefit and planned amount, with the plan year end shown. Found and recovered are kept separate on screen. Calibic does not send the letters or texts today; campaigns are coming, and the list is worked by your team.
Next step: estimate your own December with the expiring benefits calculator.