Invisalign Creates Greater Profits for Orthodontists

Invisalign Creates Greater Profits for OrthodontistsIs Invisalign a smarter braces treatment for an orthodontist’s bottom line?

A new study suggests some truth to this by revealing that, while Invisalign clear orthodontic aligners cost more in materials than conventional edgewise braces, they require fewer patient visits and a shorter duration of treatment for dentists.

Researchers reported this finding at the recent American Association for Dental Research annual meeting, according to Medscape News.

Researchers evaluated the records of 150 dental patients with mild to moderate class I malocclusion. The types of orthodontic procedures were matched for the amount of initial malocclusion and the number of rotated teeth.

According to Medscape News, here’s what they found:

Conventional braces required a median of 13.6 minutes for a routine visit, whereas Invisalign required 9.9 minutes. Emergency, initial, and final appointments were all longer than regular visits.

Conventional braces required about 2.6 more visits than Invisalign, treatment for 2.4 months longer, 1.1 more emergency visits, 9.7 minutes more in chair time, 1.2 minutes more emergency doctor time, and 86.2 minutes more in total chair time.

However, Invisalign cost $500 to $1441 more in materials and required 5.9 minutes more doctor time than conventional braces.

Measuring profitability as fees minus the cost of materials, Invisalign was more profitable than conventional braces, the researchers found, especially for Invisalign providers who are charged $899 in lab costs, a discount that the appliance maker, Align, offers to orthodontists who do more cases.

For these doctors, Invisalign provided about $1000 of profit per hour of chair time with the first $2750 in fees to the patient, rising to $3250 with $6000 in fees. Doctors who are charged $1549 in lab costs by Align had a profit of about $500 with the first $2750 in fees, rising to $3000 with $6000 in fees.

Braces were less profitable overall, starting at $750 per hour of chair time with the first $2750 in fees, but reaching only $2000 with $6000 in fees.

Invisalign is clearly the profit-maker when it comes to adding value to an orthodontist’s practice.

For more on this story see: Study Shows Invisalign More Profitable Than Braces

Dental Braces: Once Again Texas Makes News with Braces

Dental Braces: Once Again Texas Makes News with Braces What is it with Medicaid dental care and braces in Texas?

The Texas Health and Human Services Commission, which administers Medicaid in Texas for dental braces, has filed a request to be reimbursed for $7.5 million in alleged fraudulent claims it paid to Amarillo orthodontist Dr. Michael Goodwin.

Federal authorities also moved to seize the commercial and personal bank accounts of Dr. Goodwin and his wife as part of a probe linked to a Medicaid fraud scheme, according to the Amarillo Globe-News.

In 2008, Dr. Goodwin became an individual Medicaid provider, which allowed him to bill Medicaid only for services personally provided by the orthodontist.

Soon after the change, the Amarillo orthodontist was reported as scheduling up to 400 Medicaid patients a day and allegedly billing the government for orthodontic treatment he did not perform. The Globe-News further reports that patients and former employees likened the Amarillo Medicaid fraud scheme to “herding cattle.”

In 2009 the Texas Attorney General’s Office’s Medicaid Fraud Control Unit was alerted to the fact that Goodwin was likely billing Medicaid for work done by dental assistants, who worked on dental patients that state law prohibits them from doing “at Goodwin’s direction and without his direct supervision while Goodwin was out of town, away from the office or even while present in the office,” according to an affidavit for the case.

The affidavit further states that Dr.Goodwin scheduled patients in 10-minute increments, “causing pressure for assistants to practice dentistry quickly” and eventually billed Medicaid for their work.

It goes on to outline the fact that Dr. Goodwin would fly from Texas to dental offices in Indiana almost every month, while billing Medicaid for orthodontic patient services in Amarillo on dates when flight records showed he was clearly in Indiana.

The majority of Goodwin’s patients were Medicaid recipients with some reporting that figure could be as high as 95% of his dental practice.

Unfortunately, this is not a new dental braces trend in Texas …

Last June, The Wealthy Dentist reported that in 2010, Texas spent $184 million on Medicaid orthodontics — more than the rest of the United States combined. Dentist Richard Malouf’s All Smiles Dental Centers of Texas collected $5.4 million from Medicaid orthodontics. Since that time, All Smiles’ Medicaid orthodontics billings nearly doubled to $10.2 million.

In September we further reported that WFAA-TV had uncovered that Texas taxpayers had spent $424 million on orthodontics for children under Medicaid. Taxpayers spent $100 million in 2008 and $140 million in 2009 — above the $184 million spent in 2010.

On March 1, 2012 Texas implemented a new managed care Medicaid dental program, only time will tell if this will stem the bleeding of taxpayer money on braces in Texas.

For more on this story see: Feds Link Orthodontist to Medicaid Fraud Scheme

Invisalign Cost: Invisalign Braces Fee Analysis

According to the Invisalign website, the national average cost for Invisalign treatment ranges from $3,500 to $8,000, with the national average at about $5,000.

The Wealthy Dentist conducted a survey to determine what dentists and orthodontists are charging for Invisalign.

The results from the survey revealed that Invisalign treatment costs an average of $4,622 when provided by a dentist and $6.945 when treated by a specialist.

“We adjust our cost according to how long treatment takes. Times can range from 5 – 18 months (rarely more). We are willing to “deal” on Invisalign because the actual Dr. time is so minimal,” reported a Minnesota dentist.

The cost of Invisalign treatment is on average $500 higher than the cost for regular braces treatment. The dentists who responded to this survey noted that the higher cost reflects the lab fee that they pay for the Invisalign trays.

Here’s a sample of what dentists had to say about the cost of Invisalign treatment:

“I take into consideration material cost of impressions for both initial and refinement, the lab cost and shipping. We charge $5,000 for a full treatment.” (Georgia dentist)

“I have wrestled with the most appropriate fee levels for Invisalign for a long time. We have historically kept the cost of a ‘full’ treatment a bit higher than traditional orthodontia. Although the ‘full’ treatment cost is $5800 — I charge $3200 for express.” (Washington orthodontist)

“Specialists usually get ‘tougher’ cases, so they charge more. We have three fee structures for simple, medium, and complex.” (California dentist)

“My Invisalign rep suggests that I should lower my fees or offer financing that takes a bite out of my profit due to the economy, but I don’t see them lowering their lab fees to me!” (Illinois dentist)

“I hate how high the lab fee is!” (General dentist)

“Invisalign pre-treatment of prosthetic cases greatly reduces the complexity and cost of many restorative challenges. Talk about a revenue enhancer! Invisalign is the best thing this GP has added to the bag of tricks in the last 4 years!” (Florida dentist)

“I am thinking of lowering my fees to compete with the general dentists in the area …” (Oregon orthodontist)

“Clear Choice is much lower in cost to the dentist (and the cost savings can be passed along to the patient). Clear Choice appears to be just as good, if not better than Invisalign. I’m so fed up with Invisalign and our local rep is not very helpful either.” (Ohio prosthodontist)

“Our cost includes whitening and first set of retainers, which we make in house.” (Connecticut dentist)

“There is no free lunch!” (Ohio dentist)

For more on this survey see: Fees for Invisalign Treatment Average $4,622 – $6.945

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