The number one trend we’ve noticed is dentists leaving Delta Dental. It’s no mystery that dental insurance causes headaches for dental offices across the nation.
Working With Dental Insurance
We have rubbed shoulders with all the major dental insurance providers in the nation for many years. We worked very closely with many of them when we passed the “Network Leasing, Downcoding, and Bundling Protections Law” in 2020. As one of the biggest providers, Delta Dental seems to cause the most grief for dental offices. Most dental offices spend hundreds of hours every month trying to get reimbursed by insurance companies. With the cost of living increasing, these reimbursement rates simply don’t cover the cost of doing high-quality dentistry.
Since dental insurance doesn’t cover the cost of high-quality dentistry, dental offices feel pressure to do the following:
- Buy the cheapest materials
- Use the cheapest labs
- Write off the difference
- Drop insurance
We’ve noticed offices implementing one or all of these tactics. However, in this situation, someone almost always loses whether it’s the dental office or the patient. More expensive materials are typically stronger, prettier, and more durable. While some patients may want the cheapest materials, the majority are willing to pay extra for better quality. Regardless, dental insurance pays the same whether you use expensive or cheap materials, medications, or technology. Offices that use more expensive materials find themselves writing off thousands every month.
The Goal: Increased Profitability
Dental offices typically drop insurance in hopes to increase profitability. While some areas in the United States can support a full fee-for-service practice, most areas cannot. As frustrating as dental insurance can be, it brings patients to your office. Many American consumers will only go to a dental office that accepts their insurance plan. Contrary to popular belief, you don’t have to drop insurance to increase profitability. After years of studying dental insurance contracts and state dental laws, we’ve uncovered three ways to increase profitability within the confines of dental insurance contracts.
Spoiler alert: Dentists don’t need to drop Delta Dental to increase profitability. Let’s get to it.
1: Negotiate Fee Schedules
Beware Fee Negotiation Companies
There are several companies that negotiate fee schedules, and unfortunately, some of them have been banned by insurance companies. The insurance companies won’t even talk to them, but they won’t tell you that. Our team gets pretty aggressive dealing with insurance companies, but it’s still important to treat them with respect. Most of these companies overpromise and underdeliver. They promise massive fee increases for an astronomical price. After they’ve negotiated, you’ll see a $4-5 increase here and there. While those small increases may seem significant in the long run, they barely cover the cost of hiring the company to do the negotiations in the first place. And they most certainly do not bring the procedure to a positive net revenue.
Do It Yourself
The best solution is to negotiate fee schedules in your office. It’s more simple than you think, but it can require time and patience. Here are a few important points to remember when negotiating fee schedules:
- Negotiate every 2 years. If you miss the deadline, you may have to wait another 2 years. This means that your fees continue to stay lower than preferred.
- Compare all the code changes. While you may see increases on some codes, pay attention to the other codes that decrease.
For more details, attend our Office Manager Training. We discuss fee negotiations in depth so your front office team will be a pro in no time.
One Company That ACTUALLY Works
The Dental Cooperative is the only company we’ve worked with that actually improves fee schedules. They create real results for a reasonable price. We truly support this company and don’t get anything by recommending them.
A Word of Caution
Negotiating fee schedules can increase gross revenue by 1-4% at best. While that increase can make a difference, it still doesn’t cover the cost of the materials and your time. This tactic alone isn’t enough to create a profitable practice.
2: Offer In-House Plans
The Benefits of In-House Plans
A lot of consumers keep dental insurance because it makes them feel like they’re getting a discount. Little do they know, most of the time dental insurance only covers the cheapest materials. Offering In-House Plans helps patients get real discounts on their procedures, and helps your office retain profitability. Most patients are thrilled to get even a 5% cash discount, and in-house plans are typically less expensive than the dental coverage they currently have. It’s best to promote in-house plans during the insurance renewal time. Educate your patients on how dental insurance works, and the benefits they can receive through an in-house plan. Dental practices typically see a 1-6% overall increase in net revenue, depending on the size of the practice and the number of patients using the in-house plan.
Things to Avoid
While there are many benefits to offering an in-house plan, there are some risks if implemented incorrectly. The biggest risk is getting accused of offering insurance without a license. It’s very important that the patient knows that your in-house plan is NOT insurance. It’s more like a membership or discount club. We know several offices that almost lost their practice because they implemented an in-house plan incorrectly. This is one area we don’t recommend that you create the plan within your office. When researching companies that offer in-house plans make sure they have a strong legal team and know the difference between insurance and a discount plan.
The best company we’ve found for in-house plans is Illumitrac. They set everything up seamlessly, which makes the process simple for our office and the patient. Unlike other companies, they have a legal team ready to help if an insurance carrier tries to come after you. We’ve done a lot of research with these guys and they really know what they’re doing.
3: Drop the Worst Plans
There’s a reason this is the last recommendation. It’s important to try negotiating new fee schedules and implementing an in-house plan before dropping insurance. Dropping a plan means that you will likely lose many of the patients that currently use that plan. However, you can reduce that risk by educating your patients about in-house plans first. At the very least, this gives the patient the opportunity to consider different coverage options, or find a new dentist.
Review your top 20-30 procedures and determine how much you’re actually getting paid. You may be pleasantly surprised, but you may also want to drop them immediately. Once you determine your worst plans, give them the opportunity to make adjustments. It’s important to stay firm and let them know that you mean business.
Implementing these three tips can help your practice increase gross revenue by 3-8%. It can take a lot of time and effort, but in the long run, it makes a difference, but not enough to cover the actual cost of doing business. At My Practice My Business we help dental offices increase profitability with all their insurance plans. We are experts on insurance contracts and dental laws. Furthermore, the average dental practice increases monthly net revenue by 15% immediately after training. We teach principles that are fast, simple, and easy for your practice to implement. Most importantly, we guarantee our training. That means, we only make money if your practice increases revenue.
Ultimately dentists don’t need to leave Delta Dental to increase profitability. Fill out the form below for more details.
Bonus Tip: Dental Laws
In 2020, we passed the nation’s most powerful dental law to date, the “Network Leasing, Downcoding, and Bundling Protections Law.” This law prevents dental insurance from using misleading verbiage on EOBS and empowers dentists in Utah to bill fairly for what they do. When implemented, it can save a dental practice thousands of dollars every month. Dental Laws are a powerful way to promote change in the industry. Many dental associations take charge when it comes to laws, however, they might not know the benefits of this new law. It’s important to support dental associations and help them know where to dedicate their energy. We are working closely with many other states to pass this law, but it requires a lot of work and support from dentists in the state. Get with an executive in your association and help them take the next needed steps in copying our Utah Dental Law, and getting it passed in your state. For more information, don’t hesitate to call us here at MPMB: 801.226.4420.