The Dental Insurance Conundrum

May 20, 2014 No Comments by

How Dentists Can Avoid the Trap of Compromised Care.

Recently the ADA News published an article with the headline: “Dentists remain cautious about economic conditions in their practices.” I was baffled and dumbfounded by the inherent negativity of such a headline. It really does nothing but confirm to dentists that the economy is bad, when the economy is actually much better than it has been. According to an article published in the Wall Street Journal on January 1, 2014 titled, “Hopeful Signs for U.S. Economy in 2014,” at least four main economic indicators point to economic growth in the United States: unemployment has dropped, home prices have risen, consumer spending is improving, and household wealth has increased. Economists believe that such indicators paint a brighter future for 2014 than for any of the previous five years.

Unfortunately, even though the economy is improving, many dentists still have a pessimistic economic outlook and are reacting likewise. Instead of offering the best treatment options to their patients, they are instead only offering what dental insurance will pay for, which in my opinion, is generally below the bare minimum of what people really need. Currently, many insurance companies pay a yearly maximum of one thousand dollars, which at the end of the year, only pays for very minimal treatment for many patients.

Consider, for example, if one of your patients needs 20 crowns in order to be restored to full oral health. With the current payout rate of insurance providers, it would take approximately 20 years for that patient to get the proper dental care that he or she needs (if insurance is solely used to pay for treatment). At that rate, both you and your patient will be lucky if you’re around to see the process completed to fruition.

Now is not the time to be cautious about the type of dentistry you offer in your practice.

It’s a scenario exactly like the previously mentioned one that inspired me to coin the phrase, “The Dental Insurance Conundrum.” Since health insurance arrived in the dental profession more than 40 years ago, I’ve had a love-hate relationship with it. I’ve loved it because it brought new patients into my practice. I’ve hated it because the insurance companies tried to tell me what fees I should charge and the type of dentistry I should perform.

When insurance companies have the ability to dictate treatment (based on what they are willing to pay for and not on what is actually needed), some dentists find themselves slowly falling into a trap of compromised care. Compromised care is seeing and doing ‘onesie-twosie’ cases instead of the comprehensive care that patients really need. Unfortunately, once dentists accept insurance reimbursements as the primary way to get paid, we also start shopping around for cheaper materials and ways to cut costs.

The net result is a compromised level of care. The attitude of being “the best dentists we can be” changes. We are now the “the best dentists that the insurance companies will pay for.” And who wants to be that type of dentist? I know I sure don’t. At the end of the day, with this scenario the insurance company makes the profits while dentists struggle to be compensated at a level commensurate with our education. If dentists rely solely on reimbursements from insurance companies, then the insurance companies will dictate how dental practices operate.

Personally, I refuse to let insurance companies dictate the results of my hard work. Because of my mind-set, I have taken control of my relationship with dental insurance companies over the years. Instead of letting insurance companies benefit from my labors, I switched the focus and put myself in charge. When I did so, the insurance companies benefited me and my practice, instead of the other way around. I did this by presenting comprehensive treatment options to my patients, accepting what portion the insurance reimbursements would pay, and then helping patients to find other financial options for the remaining balance.

This method has worked successfully with many of my patients. But what about those patients who only want the treatments that the insurance companies will pay for? What should be done to help those patients and avoid the dental insurance conundrum? My approach in life has always been to only worry about the things that I can do something about. And I recommend the same for other dentists. Simply focus on the things that you can do to make a particular situation better. For example, you can help people with insurance who only want to be treated for things that their insurance will cover. Invite them into your practice with open arms and show them what comprehensive dentistry is really about. Once patients see dentistry in terms of how it can enhance their lives, the question of what insurance will and will not cover becomes less of an issue.

When dentists learn to see and diagnose comprehen-sively, we will offer treatment options to our patients that will truly make their lives better!

When dentists learn to see and diagnose comprehensively, we will offer treatment options to our patents that will truly make their lives better and more comfortable for many years to come. Dentists should stop seeing insurance as an albatross around our necks, and instead view insurance as a vehicle that can help us introduce dentistry’s true potential to new patients. For some patients, if they do not have dental insurance, then they believe that they can’t afford dental care. So, for such patients, simply having insurance inspires them to call and make the appointment in the first place. Even though the one-thousand-dollar maximum per year isn’t much; for some patients, it is a starting point. It’s something that helps patients take that first crucial step and make the call. Then, once they get into the office, it’s our job to help guide them into taking the next steps towards the world of comprehensive dentistry.

I’ve always said that success is very easy: you simply just copy it. Success comes by doing the right thing and knowing that the benefits will follow. The structure that Tawana Coleman and the other members of the Dr. Dick Barnes Group teach is based upon the basic principle of value-based comprehensive dentistry. If you want to attain a new level of success in your practice, then start copying your peers who have already found it. Follow in the footsteps of the thousands of dentists who have used the Dr. Dick Barnes Group’s structure and have discovered new levels of productivity.

Now is not the time to be cautious about the type of dentistry you offer in your practice. No, on the contrary. Now is the time for you to take back your practice and become more productive! By doing so, you’ll become the dentist that you have always dreamed of becoming. Regardless of a good or bad economy or any financial restrictions that might be placed upon you by insurance companies, you can do something about your practice, your attitude, and your choice of offering comprehensive treatment to your patients. Remember, the only thing that can stand in the way of your success is you!

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Editor's Commentary, Spring 2014

About the author

Dr. Dick Barnes is the leader in practice development for today’s cosmetic practice. A graduate of Marquette Dental School, he began his general dentistry practice in Rialto, California. As his practice, skills and reputation grew, he became known as one of the world leaders in cosmetic dentistry. In addition, Dr. Barnes taught at Loma Linda University and the University of Southern California, at their respective dental schools.
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