Dental Insurance: Master the Game

If you heard our podcast, Exit Your PPOs WITHOUT Losing Patients, you’ve heard high-energy Tamara Whitley raving about how her and Dr. Bill’s practice was freed from the albatross of dental “insurance.”  This is your opportunity to learn more and we encourage you to make arrangements to attend.  The insurance market is skewing more and more against you, the dentist.  Your costs are going up with increased salaries, supply costs, and the like.  But raising your procedure fees does NOT increase revenue from your patients on PPO plans—essentially accomplishing nothing.  If PPOs are a large portion of your practice, you can expect diminishing profits each year. 

Instead consider the possibility of FREEING YOURSELF!  Register now! The event is live in Frisco, Texas and not available to stream.  We hope to see you there!  Your friends and colleagues are welcome also, so feel free to share!   Please note, Edwards & Associates PC receives no compensation from this event or its sponsors.  We are simply passing along what we believe to be valuable information for you.

The Game of Dental Insurance

Summary Brief:

There are many assumptions and misconceptions about the dental insurance industry. Dental benefits are complicated, confusing, and inconsistent. Insurance policies vary from carrier to carrier. The nature of the industry is dynamic, with carriers altering their strategies in response to various market influences. Networks expand and contract. It can feel impossible to get your head around the whole system, much less understand it well enough to stay ahead of new developments.

Making matters even more difficult for providers, dental insurance in America appears to be an unregulated industry, at least as far as doctors are concerned. In fact, there is limited legal regulatory structure governing the relationship between carriers and providers. Providers have few options for recourse available outside of litigation.

Insurance companies have been able to forge their own ubiquity, wedging themselves between providers and patients. They created the game, wrote the rules that dentists must play by, and continue to change the rules to maintain their advantage.

Lacking clear understanding and practical knowledge of how the dental insurance game is played, providers and office managers often feel powerless to escape low-paying contracts. Accepting the status quo, they feel they must rely on networks for access to patients. They search for other solutions by looking for ways to renegotiate fee schedules, lower expenses, or increase their patient volume. We see these tactics as treating symptoms, not the cause.

Solutions 101 takes a unique, provider-centered approach to solving dental insurance problems; whether you are completely in network, out of network, or a mixture of both. We think that if providers have the same knowledge and understanding that carriers do, they’ll be able to regain financial control and avoid being trapped in unprofitable contracts. Our objective is to empower practice owners and office managers to make better informed decisions as savvy business owners. We think that once they know how the game really works, they’ll be able to stop playing.

Discussion Topics:

Networking: Leased vs. Direct
Are you Busy or Profitable? Zip Code vs Percentile UCR Lists & In-house Plans