Most dentists will admit to feeling trapped by dental insurance companies who continually lower reimbursement rates, question treatment plans and delay cash flow. However, they feel increased pressure to be in network because patients with dental benefits are more likely to go to the dentist, take their children to the dentist and receive restorative care than uninsured patients. Without the dental insurance companies who ensure coverage on preventative care, dental visits would decrease.
But just because PPO participation is usually a necessary evil, doesn’t mean there aren’t options to profitably decrease dependency. One of those options is to add focus to uninsured patients. According to an article released by the National Association of Dental Plans, 114 million Americans did not have dental coverage in 2016. This number is on the rise due to retirement rates and employers who are choosing to opt out of dental coverage due to high costs. As a provider, it is your opportunity to attract these patients to your office and offer an affordable option that promotes oral health.
Providers can choose to gain uninsured patients through participation in Insurance Discount Plans or by creating their own In-Office Savings Plan. Both options allow patients to feel and act more like insured patients. Patients pay an affordable annual fee to gain access to dental savings. They receive benefits over traditional dental coverage such as no monthly premiums, no annual limits, no paperwork, and coverage on advanced dentistry and cosmetic work. While the concept of providing coverage to uninsured patients is the same, there are significant differences on the part of the patient and the provider. It is important to understand these differences before deciding which is best for your practice.
Insurance companies and other third parties have created Dental Savings Plans targeting uninsured patients. These predesigned plans are covered by dentists nationwide. Patients sign up and pay an annual enrollment fee online through the third party. They are then given a list of providers in their area who participate in the program. These providers have agreed to the reduced rates outlined in the plan. In many situations, these plans offer additional benefits such as prescription coverage and vision. Patients benefit from reduced fees on defined procedures. Providers benefit because instead of processing insurance claims they are paid directly by the patient based on the reduced rate. Some plans also reimburse the provider up to 40% of a referred patient’s annual enrollment fee.
In-Office Savings Plans are created and customized based on the needs and business strategy of individual practices. The provider designs a savings plan and charges an annual upfront payment in exchange for specified included services and procedure savings. An In-Office plan is a direct agreement between the patient and the provider and is only valid in their office. The exclusivity of the plan ensures patient loyalty and retention. Patients benefit from 100% coverage on preventative care as well as savings on other dental services. Providers benefit by eliminating third-party involvement. The provider controls the annual fee, the savings percentages, and most importantly, collects 100% of the enrollment fee. The agreement is simplified and targeted specifically to your area.