Chained to Dental Insurance

Dental insurance always seems to be a hot topic in the profession. Lately, though, it has been a hot button issue in Massachusetts. Over the past few months, I ...
March 29, 2017

Dental insurance always seems to be a hot topic in the profession. Lately, though, it has been a hot button issue in Massachusetts. Over the past few months, I have witnessed the influence and power of dental insurance companies. The impact these companies have on dentists vary from whether you’re a practice owner or a new dentist like me. Regardless of your position, dental insurance doesn’t seem to be going anyway any time soon. The question for me is, do you choose to follow the pack or jump ship and try to survive without them?

Over the past few months, a war has been waging against Massachusetts dentists and one of the largest dental insurers in the state. Essentially the insurance company is planning to cut reimbursement rates by as much 20% with no added benefit to the provider other than maybe an increase in newly insured patients. But let’s be honest, 20% is a big decrease and last time I checked reimbursements, like wages, should increase as the cost of living expenses increase, right? Well regardless of what I thought, I really had no say on the situation as an associate. My practice decided for me that I was going to continue to take the insurance.

My exposure to dental insurance has been minimal since starting to practice. In dental school, insurance was one of the last things I ever thought of, and most of the time my school worked out any financial issues that held the patient back from treatment. But now in private practice, where such resources are not available, dental insurance is always in the back of my mind when treatment planning. And I’m not just talking about those full-mouth restoration treatment plans. I’m even talking about the upcharge some insurances still have for composite fillings!

So why do I have to take these dental insurances? Why should patients even have dental insurance? Are they really benefitting? Am I really benefitting?

As a new dentist, I will say that accepting several different dental insurances has given me a steady flow of patients. And in many cases, patients with dental insurance have been more likely to accept larger treatment plans. Still, there is a vast majority who have turned down treatment together because their insurance provides no coverage, or I’m having to provide alternative-alternative-alternative treatment plans that maximize the use of a patients’ insurance while somewhat addressing their dental needs. I don’t know a single dentist that wants their treatment to be dictated by someone else, but alas here we are.

Whether it’s medical insurance or dental insurance, radical reform is needed. If we ever expect to get to a place where we can make patients healthy and afford to keep our office doors open, the middle man has got to go. Will it happen in my lifetime? I actually think we might get pretty close. And there are some very powerful people in our profession who actually agree! Until then, I’m staying focused on building my practice and improving my skills. If I can provide exceptional care with insurance standing in my way, imagine what I can do with it out of my way.

Share your dental insurance experiences in the comments below. Feel free to call out my jaded optimism or to offer up your own solutions to the problem!

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