Tag Archives: Reducing Costs
Ways That Dental Plans are Reducing Their Costs
Let’s examine how dental plans are reducing their costs in 2018. The Dental Insurance Plans have shifted their marketing position with the stated goal of “reducing the cost of dental care”. Here are five Plan behaviors to consider in the current Dental Market:
The FIRST way dental plans are reducing their costs
Dental Plans are limiting or eliminating participation with the higher paid components of their Plans. Some of the Delta Dental arrangements are specifically limiting access to their Delta Premier network, requiring participation with the PPO plans.
The SECOND way dental plans are reducing their costs
Leased Network Arrangements create the opportunity for the Dental Plan to pay patient claims at the lowest fees possible.
The THIRD way dental plans are reducing their costs
The Dental Plans are demanding more money to be refunded, and, in some cases, are reducing future payments to the practice. The Dental Plan policies are national and may conflict with the State Dental Regulations. Dispute the refund in writing and contact your state Dental Association.
The FOURTH way dental plans are reducing their costs
The Dental Plans are reducing costs by implying that the practices must accept electronic payments, either by Electronic Funds Transfers (EFT) or Virtual Credit Cards (VCC). Please note that you do not have to participate and can decline electronic payments. If you are paid by VCC, contact the Plan or Third Party Vendor and request a paper check. Do not process the credit card payment if you do not want future VCC payments received.
The FIFTH way dental plans are reducing their costs
Medicare components are being added to most commercial Dental Plan contracts. These payments are partially governmental and therefore require additional training and policies, such as Fraud, Waste, and Abuse. Minimal payments come from the Plans. The practice can decline participation with the majority of the Medicare components of the Dental Plans. An opt-out letter can also be submitted to the Centers for Medicare and Medicaid Services (CMS).
The market changes will impact your ability to acquire a practice while maintaining the existing Dental Plan fees schedules. The practice may be required to add associates to the lower paid component of the Dental Plan. Remember that the practice has a contracted fee schedule and the doctor should be paid for patient care.
