Uncategorized |3 min read

Network Nonsense

Insurance

Who is not frustrated with insurance? “My insurance never denies anything and pays for everything I need without fail” -said no one ever! If you think medical insurance is a joke, you should investigate dental insurance. Really dig in and see what it is and most importantly what it isn’t.

Dental insurance was conceived in the late 1960s and really made an appearance to the market place in the 70s. It was introduced as a pre-payment plan, if you will, with a maximum benefit of $1000 per year. Yes, 40 years later the maximums for dental insurance are still the same. If dental insurance had kept up with inflation, in 2019, we would all have a benefit of around $10,000. Just think of the dentistry we could accomplish with such a benefit!

Delta Dental was the pioneer in the dental insurance industry. Soon after its introduction, PPO plans elbowed their way into the mix. PPO stands for Preferred Provider Network. Your insurance company contracts with a “network” of dentists to provide services for a reduced fee from their normal office fee.
So in theory patients’ $1000 should go farther seeing an in network dentist. However the problem we are currently facing is that while your maximums have not increased in 40 years, in network fee schedules have not changed much either. So the cost of dental materials, labs and staff salaries continue to increase and insurance reimbursements for “in network” dentists have not. Dental practices have to find a way to compensate for this lack of payment to avoid losing money.

To combat the lack of fair reimbursement from dental insurance companies, several scenarios have emerged inside the dental industry. First we have corporate dental offices that are in network with almost every insurance company. Their strategy for making money in order to offset lower fees is an increase in volume. In this scenario the standard of care is compromised with an increase in the volume of patient flow. For private practice dentists increasing volume is near impossible. What is their solution? Cut costs! So they find themselves having to use cheaper and lower quality labs and materials in order to maximize profit.

At Allen Family Dentistry we have been “in network” with three of the major dental insurance companies from the beginning. We too have had to look at ways to cut cost in order to offset the antiquated fee schedule. The results though were not the type of dentistry we believe in, support or want to be apart of. We hold ourselves to a high standard of care that ensures we treat our patients like family. Cutting corners is not how we want to treat our family! We want our family to have the best! The best materials, the best technology, the best experience, the best care! Your insurance DOES NOT want that for patients! They want to payout the least amount of money for dental services in order to maximize profit.

We have vowed not to diagnose and treat patients based on what insurance pays for but rather what is the best for the patient. Since we don’t allow insurance companies to dictate the care we give our patients, we are considered out of network with all dental insurance companies. We will still take and file your insurance (if you have a PPO plan). We will always help maximize your dental insurance benefits and help you afford your dentistry. In addition, we decided to take on the dental insurance dilemma ourselves by offering our patients an In-House Membership plan, Plan for Health. This plan has benefits, we believe are much better than traditional insurance and much more affordable. For more information about our in office membership or how we can help with your current dental insurance plan, please call or email us.

By Brittany Allen

6 comments on “Network Nonsense”
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