Answer Dental Insurance and Health Scheme Questions on WhatsApp
This recipe handles coverage questions in two parts. AeroChat gives your clinic’s general rule from your coverage notes, then collects what your front desk needs to check the specific case and passes it on. It never tells a patient their treatment is covered. Part of the dental clinic workflows.
What happens today
“Can I claim my wisdom tooth surgery on insurance?” “Can I claim from my company insurance?” “Do you accept the government dental scheme?” Each one needs a careful answer, because a wrong yes becomes a billing dispute. So the front desk replies “please call” or waits until there is time to look it up. The patient, who only wanted to know whether to book, waits too.
The general rule and the specific case
Most coverage questions have a general answer your clinic gives every time, and a specific answer that depends on the patient.
- Private dental insurance. Coverage depends on the insurer, the policy, any waiting period and annual limit, and whether your clinic is in the insurer’s network.
- Government health schemes. Where a public scheme or subsidy covers dental care, it usually applies to some procedures and some patients, at clinics that take part. Whether a specific patient qualifies depends on the procedure and their eligibility.
- Company insurance and employer panels. These depend on the employer’s plan and whether your clinic is on the panel.
Write your clinic’s version of these in your coverage notes. AeroChat gives that general answer, and your team confirms the specific one.
The flow that works
- The patient asks whether they can use their insurance, a government health scheme or a company panel.
- AeroChat answers with the general rule from your coverage notes, including which schemes, insurers and panels your clinic accepts.
- It asks for the treatment, the insurer, scheme or company name, and whether they want to book.
- It tags the conversation and passes it to the front desk with those details.
- It tells the patient when to expect a reply, and offers to book in the meantime if they want to.
The recipe
Copy this into AeroChat
When a patient asks whether their insurance, a government health scheme or a company panel covers a treatment, follow these steps.
- Answer with the general rule from our coverage notes. Say which schemes, insurers and company panels our clinic accepts. Never tell a patient that their specific treatment is covered or how much they can claim.
- Ask which treatment they are asking about, and the name of their insurer, scheme or company.
- Do not ask for ID numbers, policy numbers or medical details in the chat. Tell them the front desk will check these at the visit or by phone if needed.
- Tag the conversation “coverage check” and hand it to the front desk with the treatment, the insurer or scheme, and whether the patient wants to book.
- Tell the patient a team member will reply with the details, and when. Example: “within our next working hours”.
- If they want to book while they wait, start the booking.
If the patient describes a symptom, stop and hand the conversation to a person straight away. Reply in the patient’s language.
Write your coverage notes and your reply time before you paste it.
What to connect
- Your coverage notes. Upload a short document to the AeroChat knowledge base: the schemes you accept, the insurers and company panels you are on, and the general rule for each. Keep it current when a panel changes.
- Handover and tags. AeroChat’s own handover passes the conversation to the front desk with the tag and the details. Your team picks it up in the shared inbox or the mobile app.
- Booking. If the appointment booking workflow is set up, patients can book while the coverage check is pending.
Using a different system? If it has a public API, it connects to AeroChat the same way: describe what you want, paste in its key, and it runs.
Can’t find your tool? Message us in the chat on this page and we’ll tell you how it connects.
What you still decide
- The general rule for each scheme, insurer and panel, in your own words.
- Who on your team handles coverage checks, and how fast they reply.
- Whether a patient can book before the coverage check comes back.
Confirming coverage stays with your team. AeroChat gives the general answer and gathers the details.
The result to expect
Patients get the general answer at once, so those who are only asking whether your clinic takes their insurer or panel know straight away. The front desk receives each specific case with the treatment and insurer already collected, and answers it once. Fewer patients turn up expecting a claim their policy or scheme does not allow.
Next: treatment price questions and symptom handover. See also live chat handover.
Write your coverage notes first
A one-page note on the insurers, schemes and panels you accept is all this recipe needs. Upload it, paste the recipe, and ask it whether your clinic accepts a patient’s insurance for wisdom tooth surgery.
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