“Sorry, Ma’am, I Didn’t Write Your Policy” — How to Handle Waiting Period Blame Games in Dentistry

“Sorry, Ma’am, I Didn’t Write Your Policy” — How to Handle Waiting Period Blame Games in Dentistry

July 17, 20254 min read

Ah, the magical moment when your patient finds out their brand-new dental insurance doesn’t actually cover anything today. Or tomorrow. Or for another 6–12 months. That’s right: they bought a policy with a waiting period.

And who do they immediately point their freshly-polished finger at?
You.
The dentist.
Obviously.

Why? Because insurance companies have spent the last 40 years carefully crafting a brilliant little scheme where they sell limited-benefit plans, hide the fine print behind rainbows and puppies, and let the dentist take the heat when it blows up in the patient’s face. It’s almost poetic and entirely infuriating.

So let’s have some fun with this mess while giving you the tools and scripts to keep your cool (and your dignity) when it inevitably happens again next Tuesday at 10:15 a.m.


🎭 The Theater of the Waiting Period

Act I: The Setup
Patient buys shiny new plan. Patient hears words like “coverage” and “benefits.” Patient assumes this means everything is covered immediately.

Act II: The Reveal
Treatment plan is presented. Insurance benefits are verified. Front office gently explains that insurance won’t pay for today’s crown because... cue drumroll... there’s a 6-month waiting period.

Act III: The Blame
Patient gasps, looks horrified, and mutters:

“Why didn’t you tell me about this when I bought the plan?!”

Yes, they think you, the dentist, moonlight as their personal insurance advisor, plan selector, and clairvoyant policy reader.


😂 Why It’s Not Your Fault (But Feels Like It Is)

The insurance company knows full well that most patients don’t read (or understand) their policy. And they sure aren’t going to take responsibility for how confusing and deceptive their marketing can be. Why would they?

They don’t even have to deal with the fallout — because you do. And by now, that’s practically part of their business model.

But here’s the truth: You are not responsible for your patient’s insurance literacy. You are responsible for delivering excellent care and helping them navigate their benefits to the extent you can.

So stop letting their ignorance steal your joy — or your team’s sanity.


🧰 Protocols That Take the Heat Off You

✅ Verify benefits ahead of time.
Even if patients should know their plan’s details, many don’t. Do a pre-appointment verification. If a waiting period exists, call the patient before the appointment and explain what their plan will and won’t cover — and what their out-of-pocket cost will be.

✅ Use written disclaimers.
Include a note in your financial policy that insurance is a contract between the patient and the insurance company, and that your office is happy to help estimate benefits, but patients are ultimately responsible for understanding their plan.

✅ Train your team to script this well.
Your front office staff needs to be ready to handle these conversations with empathy, but also clarity.


🗨️ Winning Scripts for Awkward Moments

🎯 When verifying benefits and discovering a waiting period:

“Mrs. Smith, I wanted to let you know we called your insurance company and verified your benefits today. They told us your plan has a 6-month waiting period before covering crowns. That means if you’d like to proceed now, the insurance won’t cover their portion, but we’re happy to help with financing options if you’d like.”

🎯 When the patient accuses you of being “at fault” for their plan:

“I completely understand how frustrating this is, and I wish insurance companies explained it better when they sold the policy to you. Unfortunately, we don’t have any say in what plans offer or cover — but we’re here to help you make the best decision for your care.”

🎯 When the patient threatens to “call the insurance company and complain about you”

“That’s actually a great idea! They’re the ones who set the terms of your plan, so they’ll be able to explain why there’s a waiting period better than we can. If you’d like, I can give you the number we called to verify your benefits.”


🧼 Wash Your Hands of Their Mistake (With Class)

At the end of the day, you can’t fix stupid — but you can educate, prepare, and protect yourself. Insurance companies may continue to hide behind their policies and giggle at how often dentists get blamed.

But you?
You’ll be ready with airtight protocols, a cool head, and maybe even a sly smile as you say:

“Sorry, ma’am. I didn’t write your policy. But I’m happy to help you figure out the best way forward.”


🪥 Takeaway for Dental Teams

✔️ Verify benefits early
✔️ Communicate clearly before treatment
✔️ Set expectations in writing
✔️ Have rehearsed scripts ready
✔️ Stay kind — even when patients are clueless

And remember: insurance companies may have designed the waiting period blame game, but you don’t have to play it.

If you’d like help training your team or improving your insurance protocols, reach out — because someone’s gotta look out for dentists, and it’s sure not the insurance company.

Benjamin Tuinei
Founder, Veritas Dental Resources, LLC
📞 888-808-4513

Services:
PPO Fee Negotiation · Insurance Fee Negotiation
Insurance Credentialing · Insurance Verifications

Websites:
www.VeritasDentalResources.com
www.VerusDental.com

Benjamin Tuinei is a leading expert in PPO strategies and fee negotiations, recognized by multiple state dental associations and continuing education institutions. Since beginning his dental career in 2007, he has helped over 9,000 dentists improve insurance reimbursements, influencing more than $5 billion in negotiated revenue. His expertise in restructuring billing departments increased collections from 65% to 98%, and his negotiation skills with third-party payors boosted insurance revenue by nearly $1 million, earning widespread recognition from dental practices across several states.

Benjamin Tuinei

Benjamin Tuinei is a leading expert in PPO strategies and fee negotiations, recognized by multiple state dental associations and continuing education institutions. Since beginning his dental career in 2007, he has helped over 9,000 dentists improve insurance reimbursements, influencing more than $5 billion in negotiated revenue. His expertise in restructuring billing departments increased collections from 65% to 98%, and his negotiation skills with third-party payors boosted insurance revenue by nearly $1 million, earning widespread recognition from dental practices across several states.

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