Dental Insurance Determines Who Will See a Dentist

Dental Insurance Determines Who Will See a DentistDental insurance status is a major determinant of who will seek dental treatment, according to a Facts and Findings report by Rutgers’ Center for State Health Policy.

The report complied data from the CSHP’s 2001 and 2009 New Jersey Family Health surveys on children ages 3 to 18 who received no dental services within a year.

The study found that children with employer-sponsored or privately purchased dental insurance were much more likely to receive dental care than children without dental insurance or even those covered by publicly insured programs like by Medicaid/NJ Family Care.

According to Rudgers University news, the report also pointed to well-care doctor visits as an important indicator of the likelihood of a child receiving dental care, possibly because of efforts to increase dental referrals in managed care plans and the expansion of dental care in federally qualified health centers.

“The odds were three times as great for children who did not have a well-child doctor visit in the past year to not receive dental care as those who visited a doctor,” said José Nova, research project coordinator and lead author of the study. He noted that care for under-served children could be improved with expanded health coverage under the Patient Protection and Affordable Care Act.

Reuters estimates that 45 million Americans do not have dental insurance.

To read more on this report see: Rutgers Study: When it Comes to Use of Dental Services, not all New Jersey Youngsters are Equal

Why Dental Insurance Can Be Aggravating for Dentists (video)

Why Dental Insurance Can Be Aggravating for Dentists (video)Many dentists feel that dental insurance is the bane of their existence.

Dentists often say that dealing with dental insurance is one of the most complicated aspects of dental practice management.

In fact, most dental patients have little understanding of how their dental insurance coverage actually works.  The intricacies of dental insurance and the lack of sufficient instruction provided by some insurance companies make it almost impossible for some dental patients to properly understand their dental insurance benefits.

This creates a widening divide between patients’ expectations of their dentist’s fees and what their the actual dental insurance coverage provides.

As one prosthodontist complained in a The Wealthy Dentist Survey on dental insurance, “My patients demand that I accept insurance assignments. At first I refused, but I lost more than half of my dental patients to other practitioners accepting insurance.”

The Wealthy Dentist survey asked dentists if they see dental insurance as friend or foe.

Not all dentists who responded to the survey see dealing with dental insurance as all bad.

“Patients with dental insurance coverage are much more likely to agree to a treatment plan,” responded one dentist.

To hear what dentists had to say about dealing with dental insurance, Click on play to watch the following video —

What are your thoughts on dealing with dental insurance?

Dentist Believes Dental Insurance is Detrimental to Dental Patients

Dentist Believes Dental Insurance is Detrimental to Dental PatientsRecent statistics have stated that roughly one out of every two Americans lacks dental insurance coverage.

It has been proven that having dental insurance makes dental patients visit their dentist more often for treatment.

According to a report by the Institute of Medicine, patients who do not have dental insurance are approximately two-thirds less likely to have visited their dentist within the past year, compared with those who have dental insurance coverage.

But do these statistic tell the whole story on dental insurance?

The Wealthy Dentist conducted a survey asking dentists what percentage of their dental patients still carry dental insurance.

One general dentist responded, “We will file for all our patients but are not in network with any insurance companies. I see about 50% of patients with insurance.”

The dentists reported the following percentages of patients with insurance —

  • 29% — 50 – 70% of patients have dental insurance
  • 26% — 70 – 90% of patients have dental insurance
  • 18% — Less than 50% of patients have dental insurance
  • 13% — 90 – 95% of patients have dental insurance
  • 08% — Don’t accept dental insurance
  • 06% — Answered “other”

How dentists feel about dental insurance is another matter and here’s what they told The Wealthy Dentist in their survey responses —

“I hate dental insurance!” (Alabama dentist)

“Taking dental insurance allowances is a recipe for financial failure. Just look at the numbers.” (Pennsylvania dentist)

“Dental insurance? Bah humbug!” (Virginia oral surgeon)

“Dental insurance is detrimental to dental patients and practices.” (Texas dentist)

“Many of our patients know most dental insurances stink as far as reimbursement amounts and yearly maximums, yet 70% of them still carry dental insurance. It’s a huge factor around here.” (Ohio prosthodontist)

“We don’t accept dental insurance as a form of payment, but we will fill out their forms so they can get paid. Some insurance companies will then send a payment to us and we have to reimburse the patient.” (Illinois dentist)

“Dental insurance: love it/hate it, but so it goes.” (General dentist)

“There is a definite reduction in companies who are willing to provide dental plans and a definite move by patients to either drop their coverage or to seek out a dentist in their network.” (Texas dentist)

“Dental insurance creates more problems than it solves.” (California” dentist)

“We are not a preferred provider for anyone, but accept any insurance that allows out of network dentists. We do charge the patient the difference between our fees and what the insurance pays.” (General dentist)

“Regardless of our profession’s exhortations regarding lifelong dental health, the fact is that many people would never visit a dentist if they didn’t have dental insurance. The idea of “free” services is their motivation. If they had to pay the full cost, they wouldn’t visit the dentist at all.” (California dentist)

The Wealthy Dentist agrees with the last statement by a California dentist. Patients who have some type of dental health plan are more likely to return regularly to your dental practice and accept treatment recommendations.

This results in your dental practice having more active cases and fewer inactive patients, thus increasing your practice bottom line over time, which makes you more profits in the long run.

Dental Insurance Survey: Dentists Handle Claims For Patients

dental insurance survey

When asked if they handle dental insurance for their patients, the dentists who responded yes to handling dental insurance were the clear majority in this survey.

On March 23, 2010, the Affordable Care Act became law and as states begin to deal with the implementation of the act, several are looking to adapt their own version of the plan.

California is just one of those states.

As reported in The Sun, Democrats in California have recently revived Senate Bill 810, which would create a public-private partnership to provide every California resident with medical, dental, vision, hospitalization and prescription drug benefits.

The California universal care plan would provide comprehensive dental care – something largely not addressed in the federal plan.

Here at The Wealthy Dentist, we were curious how dentists are currently handling dental insurance in their practices. Many of the dentists surveyed felt handling dental insurance for their patients is an important part of providing superior customer service.

“Not only do we handle insurance claims for our patients, but we also fight insurance companies for our patients until a claim is finally paid,” noted one dentist. “I believe its part of how much do we as dentists want to give customer service.”

In this survey, 85% of dentists handle all insurance claim forms for patients with dental insurance, 8% don’t accept insurance, and 7% don’t handle insurance claims, but do help patients fill out the forms.

Here are some dentist comments:

  • “Many of my patients would go elsewhere if they had to pay up front for services themselves.” (General dentist)
  • “I think its a matter of customer service to handle insurance for your patients.” (Indiana dentist)
  • “I pride myself on customer service and I believe it’s an absolute no-brainer as part of my truly great customer service. My team (including me) file ALL insurance claims for our patients.” (General dentist)
  • “As a specialist where one-time emergency visits are common, we find it necessary to research insurance benefits for our patients in order to present and collect estimated co-payments at the time of service.” (Ohio specialist)
  • “I would like to see better tools for educating patients about dental insurance benefits and liabilities, as well as setting better expectations with dental insurance verses medical insurance models.” (Massachusetts dentist)
  • “Dental insurance is one of the most aggravating things about dentistry. What I would like to do is collect from the patient, then help them submit the claims.” (California dentist)

For more on this survey see: Dental Insurance: Most dentists handle insurance claims for patients

Dental Insurance and Obama Care: Who’s Right?

Dental Insurance and Obama CareThe National Journal is reporting that the National Association of Dental Plans is spending more than $1 million on a campaign to change a provision in the health care law that they feel will require some people to buy duplicate dental insurance coverage.

Let me repeat…The dental benefits trade organization is spending $1,000,0000 to hire a lobbying firm to convince the Obama administration to fix the provision by the end of 2011.

Is this a good thing? Click here for a 92-page white paper “Road Map” with Delta Dental as a co-sponsor.

The NADP is concerned that, starting in 2014, the almost 44 million people who receive pediatric dental coverage through small business employers will also have to buy coverage through the new health insurance exchanges. It is asking regulators to clarify that their existing coverage meets the law’s requirements.

“Truthfully, this is the No. 1 issue for our industry,” said NADP executive director Evelyn Ireland. “It is the most crucial thing for us to get done.”

NADP wants to ensure that people will be allowed to keep their existing dental insurance coverage under the new health care, a promise President Obama repeatedly made during the heath insurance reform debate.

For a multitude of reasons I have never been a big fan of Delta Dental. However, after reviewing the 92-page white paper I think there may be some merit to this $1,000,000 argument.

Before, I make up my mind, I would like some pro or con feedback from our readers.

Please post your comments below.

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