Is dental insurance eating your lunch? (and dinner too?)

Do you feel like the dental insurance plans you joined to increase your new patients are killing your reimbursements instead?

You’re not alone.lunch

Most dentists have joined 8-10 dental PPO plans hoping to fill the holes in their schedules and are left feeling like that strategy backfired. Now the team is struggling to manage the variety of fee schedules so that the treatment plans come out right – and still handling patients who are upset when their composite fillings get downgraded to amalgam and they have to pay $80 more than anticipated.

So, what can you do to manage your dental insurance plans?

Make sure they’re set up correctly

For each employer and dental insurance plan you’ve joined, you can attach the plan’s fee schedule. When the fee schedule is attached, your treatment plans will reflect the allowed amount and give your patients a clear picture of what their total cost will be for your treatment plan. This doesn’t protect you from getting caught up in waiting periods or downgrades, but its a good start.

Dentrix does a nice job of handling dental insurance. Not only can you attach the fee schedule for each PPO plan, but you can set up tracking for each plan as well. Then, using their Letter Merge (in Office Manager, Letters) you can run reports to find out how many active patients and  new patients you’re gaining for each dental insurance plan. You can use this information to negotiate with the dental insurance plans – or, if they refuse, to send a customized letter to these patients with the plan to let them know that you’re dropping your membership but still happy to see them out-of-network.

Compare your fees

Look at your standard fee schedule compared to what each insurance plan pays. What do you charge for a non-insurance patient to have a cleaning and periodic exam? Now, what does Delta or MetLife pay? You may feel okay about offering a 15% – 20% discount from your normal fees, but how do you feel when your discount is closer to 50%-60%? Look at your plans, do the comparison and know which plans are paying the best, and the worst.

As you’re reviewing fees, now is a good time to evaluate your own standard fee schedule. You may feel you’re getting robbed by the PPO plans, but how do you know that your fee schedule isn’t too high in the first place? You can purchase a fee evaluation for your zip code and some dental supply companies provide a fee evaluation as well. For a free way to evaluate your fees, check out this article about the Fair Consumer website.

Look at all your front desk tasks for ways to increase the bottom line

If you still have holes in your schedule despite the 8 different dental insurance plans you’ve joined, then you may want to evaluate each of the tasks handled by your front desk team to look for other opportunities to improve your bottom line. There are lots of ways you can fill your schedule and increase collections beyond managing dental insurance well. As you review each task with your office manager, you may identify several ways to schedule more patients and improve your success.

Managing dental insurance is just one way to run a successful dental practice. If you’re interested in new ideas on running a dental practice, please subscribe to my weekly blog. One of the biggest challenges to managing a dental practice is managing dental insurance. With dental insurance handled, then dental marketing for new patients becomes a primary focus. In today’s day of online reviews, handling patient complaints well is essential. As your practice grows, hiring dental staff becomes more important. With 16+ years of dental practice management experience, I’m open to your questions to help you run a successful dental office.

Feel free to email me.

AUTHOR: Jill Nesbitt
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