How to write an open access or out-of-network script
There comes a crucial window of opportunity for every eye care provider dropping one or more vision plans: The chance to explain the advantages of out-of-network benefits to existing patients and begin capturing new patients.
Some might not describe it as an “opportunity," though. They wouldn’t paint it in such a positive light. However, when you consider how dropping one-or-more vision plans may improve patient care and boost practice profitability it becomes clear it really is a moment to embrace. But in order to take advantage of this window of opportunity, you and your team will need to be able to effectively communicate your newfound value proposition.
How does out-of-network represent opportunity?
We refer to out-of-network providers as “open access.” Why? Because it more accurately captures the advantages of running your business this way—both for you and for your patients.
It’s network freedom: The chance to run your practice the way you see fit and in a way that benefits your patients. You have more control over rates and price transparency; you can reduce volume in favor of dedicating more time to patients; you can sink less time into plan administration. Like we said, network freedom.
Whether you want to refer to it as open access is up to you. But the principle behind it can help you write your scripts. How do you explain to patients the advantages of this new approach? Well, you can start with the ways in which it will open up access and opportunities for better care, better services and better products.
Explaining open access to out-of-network benefits
Vision plans can be confusing for ECPs. For members of these plans, aspects such as the nuances of in- and out-of-network benefits can be downright alien. It will be up to you and your team to break down how out-of-network actually means better care for your patients.
Before you say a word about it to patients, though, you’re going to have to write scripts, role play them and then rewrite again. Write, role play, repeat. The repetition will help ensure you get through the crucial window of opportunity without losing a large chunk of patients. And here’s where it’s important to note:
Most practices lose some number of patients during this transition. The reason it’s easy to absorb is that more revenue per patient allows ECPs to make more off lower volume. Additionally, oftentimes patients who leave ultimately come back. Historically, ECPs that drop off panel retain about 60% of their patients. The best way to keep as many patients as possible is those scripts we mentioned.
Script templates for out-of-network ECPs
We can’t leave you without script templates! ECPs should put their own spin on scripts—especially if you’re a niche or specialty provider. However, starting from scratch can be tough. These script templates will help you get rolling with your own.
Of course, out-of-network ECPs who use Anagram may have different scripts than those who don’t. For that reason, we’ll denote sections of the script that refer specifically to Anagram processes with bolded-and-italicized script.
When a patient asks if you accept a specific vision plan:
Patient: Do you accept [XYZ Vision Plan]?
Response: Yes, our practice works with all types of insurance on an ‘open-/out-of-network basis’. As an open-access/out-of-network provider, we are not contracted directly with your insurance but we can provide you with services/materials and still utilize your insurance benefits/coverage. If you provide us with a few pieces of information, we are able to pull your insurance eligibility and coverage and let you know how much you will pay for services and how much insurance will reimburse you directly.”
When a patient asks how you’re different than the competition
Concierge Practice responses:
Patient: Why should I come to see you instead of my in-network provider like [Dr. XYZ]?
Concierge Practice Response A: Our practice works with all types of insurance on an “open-/out-of-network basis.” As an open-access/out-of-network provider, we are not in-network but we can provide you with services/materials and still utilize your insurance benefits/coverage. If you provide us with a few pieces of information, we are able to pull your insurance eligibility and coverage and let you know how much you will pay for services and how much insurance will reimburse you directly.
Concierge Practice Response B: Great question! One thing we realized in the insurance market is when you go to an in-network provider, you are limited in the type of materials/frames you can choose from. You may only have 5-10 options to select from and this is dictated by the insurance plan you registered with. With us, anything you see in the store you can purchase and STILL use your insurance!
The only difference is that payment is due at the time of service and the reimbursement check will be sent directly to you in 3-4 weeks. Think of it as a rebate program! Wouldn’t it be great if you can walk out of the store looking great and feeling great without insurance dictating who you can or cannot seek services from?
Partnerships Response: Because we are an open network practice, we are not confined to the rules of your insurance policy. We have the ability to carefully select the labs we wish to work with to ensure that you get high quality of services/materials without the fear that it will break in a couple of months. We pride ourselves in the care we provide!
Standard out-of-network response:
Out-of-network response: Great question! One thing we realized in the insurance market is when you go to an in-network provider, you are limited in the type of materials/frames you can choose from. You may only have 5-10 options to select from and this is dictated by the insurance plan you registered with. With us, anything you see in the store you can purchase and STILL use your insurance!
The only difference is that payment is due at the time of service. Afterward, you’ll be able to get a reimbursement check from your vision plan provider. We’ll set you up with everything you need to work with your vision plan to ensure you’re reimbursed per your out-of-network benefits.
Selling your unique value
The scripts above are a start, but be sure to infuse them with your unique value proposition! What makes you special as an ECP, beyond the fact that you work out-of-network with some or all vision plans. This will overlap with your marketing strategy, and you should make sure that your marketing plan informs your scripts and other patient communications.
It’s all about ensuring people understand that unique value. If you can communicate it effectively, it will be clear why you’re better than the in-network alternative.