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Dentists are sick and tired of dental insurance companies dictating fees and treatments. Just over half of the dentists in this survey said that they had mostly or completely stopped accepting dental insurances.
"We still work with hundreds of insurance companies by filing the paperwork, etc," said an Ohio dentist. "But by not being ‘in-network’ on any plan, we get paid for what we do."
Dropping insurance can raise a dental practice’s bottom line, but it can also cost them patients. One-third of respondents felt that dropping insurances was not a financially realistic option for them.
Dental insurance brings patients in
- "I have a brand new office and a lot of debt. Being a preferred provider for insurance companies is not ideal long-term, but it is necessary now to get people in the door.” (Indiana dentist)
- "The other dentists in town are dropping the PPO patients that just go like sheep to the ‘preferred provider,’ so now they come to me.” (California dentist)
Drop insurance, lose patients
- “I'd be cutting ties to 85% of my patient base!” (Endodontist)
- “Patients don't understand the issues. They will move on to someone else who takes their plan at the drop of a hat.” (Minnesota dentist)
Dropping insurance is selfish
- “If you live in a wealthy area where cost of treatment is not a big factor, more power to you. Dropping insurance in my area would be financial suicide. I think that those who can't be bothered with insurance are self-serving people who have lost sight of the service part of being a professional. I became a dentist to serve people, not to exploit them.” (California dentist)
Dentists need to ALL drop insurance
- “If more dentists resisted the urge and didn’t sign on, then we would be able to do more to provide value-driven treatment to patients rather than ‘I will do what my insurance pays’ treatments.” (Illinois dentist)
- “If all dentists dropped all insurances, then ALL dentists could collect their fees in full from everyone. They could also have more leeway to give courtesy discounts to whomever they choose instead of patients who belong to certain plans.” (Virginia dentist)
Insurance encourages sub-standard care
- “Insurance has ruined medicine.” (New Jersey dentist)
- “I do not think the insurance companies should be trying to dictate treatment. They often change treatment plans to the cheapest option which is not the best for the patient.” (Kentucky dentist)
Insurance benefits are inadequate
- "It has been 48 years since dental insurance began, and the $1,000 yearly maximum has yet to be raised. That’s half a century!" (Ohio dentist)
- "Dental insurance is a joke. It's not even insurance; it's an employee benefit with ridiculously low payouts. Their goal is to not pay out a penny more than what their customer is paying in premiums. Insurance carriers get away with legalized theft, and I will not participate. I truly wish more dentists would kick them out. They are NOT a necessary evil to survive.” (Alaska dentist)
- “So-called ‘insurance’ companies must be making a fortune on dental ‘insurance.’ When these programs began in the 1960's, the limits
generally were $500-750 per calendar year. A crown cost $100 then. Now, 50 years later, a crown costs $1000, but the yearly limits are
$750-1500. The premiums have surely kept up with 50 years of inflation, but the benefits haven't. Do the math… somebody is making a hell of a lot of
money on these plans, and it is not the dentist!” (Ohio dentist)
Insurance can lead to unhappy patients
- "The unsatisfied patients are all the ones who still owe money after their insurance did not pay what the patient thinks they should.” (Maryland dentist)
- "Some of the contracted insurance patients were the most demanding, unappreciative, and always wanting to make ‘deals.’ I believe this was encouraged by the insurance company.” (Minnesota dentist)
The write-offs will kill you
- “I would like to drop all my contracted plans because the write-offs are huge!" (Massachusetts dentist)
- “It’s not easy. Some patients leave, but many come back. I have a small practice and pamper my patients, but couldn't afford losing so much in the write-offs.” (Minnesota dentist)
Who’s in charge of your fees?
- "I am a Delta Dental provider, but I am getting tired of them dictating what I can charge to my patients and how often I can change my fee schedule.” (Arizona dentist)
- “We have no contract with any insurance companies. It is a great benefit to have control of our fee structure.” (General dentist)
Even if you drop insurance, it’s nice to help patients with the paperwork
- "I have dropped all insurance plans, and patients pay us first. However, we will fill out paperwork and fight for the patient to get the benefits they are owed.” (Washington dentist)
- "We still work with hundreds of insurance companies by filing the paperwork, etc. But by not being ‘in-network’ on any plan, we get paid for what we do." (Ohio dentist)
Success – without insurance
- “Free At Last!!” (Minnesota dentist)
- “I have been in practice for 35 years. I do not, nor have I ever participated with ANY insurance program (including Delta). I never will.. I'll retire first. (BTW, I produced and collected over $800,000 last year.)” (Ohio dentist)
Success Story: New dentist avoids insurance altogether
- "I opened my suburban practice from scratch in 2003 as a new dentist with no patients. I never accepted insurances or entered into any PPOs, etc. My practice has grown fine without them. We now have over 1,300 active patients. Four years after starting my practice, my office grossed over $475,000 in 2007 operating just 3 days a week. This year we are on track to grossing over $550,000 on 3 days a week without being on any insurance plans. Next year we are expanding to 4 days a week. My staff and I are very happy to not be tied down by insurances, PPOs, etc. So far, we are very happy.” (Ohio dentist)
Success story: Everything must be perfect before you can drop insurances
- "We converted to [not accepting insurance] six years ago. We ask for payment at time of service, then send in the claim form for the patient to have insurance company pay them. Your practice must be perfect in every way prior to this change: perfect service, office, amenities, marketing, technical excellence, etc. People have to want to stay with you because this policy can rub many the wrong way. I have lost many a patient over this, but still gain many new patients every month who are fine with it. I have built a strong reputation in my community for personal service, quality, and outstanding aesthetic dentistry. Hopefully that is what keeps them coming back.” (South Carolina dentist)
Success Story: Difficult transition, but ultimately profitable
- “We stopped accepting any payments from insurance companies in 1996. It was a rough transition at the time. If I was to do it over again, I would do it a little differently, but we survived. We took a financial hit for about two years, but after that we passed all previous collection and production numbers. We provide an insurance form for our patients to send to their insurance company. The company sends payment to the patient. Our collections are 99-100% of production every year. Our accounts receivable number is usually equal to about 3 days production at any time. We are in the suburbs of a medium city. I don't know if this can work in all communities, but it works well for us.” (Oregon dentist)
Note: Survey sample included 121 respondents.