Jamie Rowley, Office Manager for Dr. Calvin Pierce, North Kingstown, RI
Jamie Rowley started in the dental field 13 years ago after she was laid off from a job doing financial paperwork for a horse trailer dealership. The dental office where her friend was looking for a front desk receptionist and she decided to give it a try. Unfortunately the rest of the staff was not very helpful in teaching her what I needed to know about scheduling patients and insurance. So she took it upon herself to learn everything she could. She would pull up a chair and watch what they did, then she would look up the insurances and go over the plans to see what was covered what was not. Jamie taught herself how to figure out patients co-pays.
Over the years, she talked with different office managers and Insurance Company representatives to see what each company’s guide lines were. Since not all dental Insurance companies are the same, you need to know what each plan allows.
- Is the patient allowed 2 cleanings a year or every 6 months?
- What age are sealants covered until?
- Are posterior composites covered?
Jamie found that keeping a notebook with all the information that she gathered helped her learn more and more about insurances. She breaks it down by procedure then by each insurance. Example: DDRI for Sate of RI covers posterior composites, DDCA: Tricare allows 2 fluoride treatments a year with no age restriction. Jamie finds it easier to do it that way then break it down by plans.
Her note book is in sections for quick reference. She has a list of what plans are 6 months to the day for cleanings, if there is a waiting period or restrictions under a specific plan, and what insurances have a grace period for cleanings if they are 6 months.
She also has a form she fills out for each new patient when they call so she can gather all the information she needs and not forget anything. She makes sure that when she puts the insurance into the computer that if there is a specific restriction/limitation she puts a note under the insurance. Some of the insurances are difficult to read /follow so she breaks them down on paper by category. “It is important to keep everything up to date because they are always changing. For example, post and core and build up are almost always the same as crowns, but this year BC/BSRI changed some of their plans so Post and core/Build up is paid at the Restorative level not major level.” States Jamie.
“It is important to pull up each patient’s insurance when they come in to make sure that they have not reached their maximum, are they eligible for x-rays and exam, etc. The more prepared you are before the patient comes in the smoother the day goes.”
Sadly, many patients only want to have done what is covered by their insurance even though that may not be what is best for them. Just because the insurance company does not cover the procedure does not mean that it is not necessary.
Jamie went to CCRI and graduated with a General Business Degree and Accounting Certificate. She has worked for Dr. Calvin Pierce in North Kingstown, RI for a little over a year. When she is not working she enjoys spending time with her family, watching her daughter dance or cheerleader and watching her son play soccer or do karate or just hanging out and spending time together.
Editor’s Note: One of the goals that the Ocean Sate Chapter of Dental Managers Society has is to compile a database of insurance companies and their guidelines to share among the group.
