Dental Marketing and Practice Management

Jim,

Reading your article on 94% of dentists being willing to confront the insurance companies, I was struck by two things. First, the obvious lack of knowledge of the history behind insurance and dentistry. All of the comments seemed to reflect an understanding of the product based on how many years the respondent had been practicing. Second, the fact that even you continue to refer to “Dental Insurance” as if there actually was such an animal.

In my office, the first thing we try to explain to patients is that there is no such thing as dental insurance as they understand the meaning of the word insurance. The patient can either purchase a prepaid dentistry up to a set dollar amount or they can join a discount shopping network.

I think that maybe we dentists should begin a movement to strike the term “dental insurance” from our vocabularies.

As a new practitioner in 1979 needing patients to fill the schedule, I didn’t heed my first office manager’s advice which was not to participate in any insurance plans. In those years, the reimbursement was not too different from the fees we were charging. Little by little, however, the fees went up and the reimbursements went down. Usual and customary fees had little bearing on the dentist who made every effort for continual enhancement through education, upgrading of equipment, and advancing customer service with competent higher paid employees. If you wanted to practice the kind of dentistry you know people deserved, you could not be profitable or satisfied consenting to the mandatory reimbursements for mediocre dentistry. The highly educated and skilled practitioners who chose to drop out of plan participation would lose patients to dentists who charged less regardless of their competency.

The difficulty was (and still is) the patient’s perception and financial resources combined with the entrenched view that dental health is not as important as the rest of the body. Dentists who reluctantly continue to participate in plans to accommodate their patients, find that if the insurance plan won’t cover the service, the patient often chooses a less expensive (and less appropriate) alternative or elects not to have the work done at all. This is a lose-lose situation and almost certainly a contributing factor in rising medical costs.

The ridiculous maximums and exclusions in dental insurance are a hindrance to overall health. Even though the scientific and professional literature document the connections of periodontal disease to heart disease, diabetes, pre-term births, and post-operative pneumonia; bite imbalances and TMJ dysfunction with headaches and chronic pain; lack of teeth and improper chewing with digestive problems and allergies, dental insurance is abysmally inadequate.

Ironically, investigating ways that I could save money on my own and employees’ increasing medical insurance premiums, I found a health insurance plan that would cover dental work. In the late ‘90s we switched our health insurance over to Medical Savings Accounts. In 2003, the government upgraded this plan to Health Savings Accounts tied to a compatible high deductible health insurance. The premiums for health insurance were cut in half and the government allows almost $3,000.00/year/individual and $$5,900.00/year/family to be put away tax free for eligible medical expenses. Unused amounts roll over collecting interest. This is the only medical plan that deems dentistry an eligible health expense. In other words, one can tap into their health savings account to pay for dental expenses, without having to file claims or predeterminations. The dentist gets paid up front and the patient doesn’t have to postpone or neglect treatment. This is a win-win situation.

In 2003, I co-founded a company, T-Horizons, LLC to help dentists learn more and acquire cost-effective consumer directed health care, both for their own personal needs and for their practice health. Patients can augment their dental insurance with health savings accounts. Dentists can obtain printed consumer brochures to educate their patients who may be searching for ways to afford their dentistry and control health care expenses. You can learn more about health savings accounts by downloading a whitepaper, “Health Savings Accounts: How Health Providers Can Effectively Use Consumer Directed Health Plans for Both Increasing Patient Revenues and Saving Thousands in Personal and Employee Health Insurance Benefits”, on our website. We would be happy to answer your questions personally.