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

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 Plans and The Affordable Care Act

Dental Insurance Plans and The Affordable Care ActAccording to the Pew Center report, approximately 5.3 million children are expected to gain dental coverage after 2014 as part of the Affordable Care Act.

The Act includes a plan for pediatric dental insurance plans that will be sold in insurance exchanges, both packaged with adult plans and as stand alone plans, as reported by Healthcare Finance News.

Joanne Fontana, an actuary who tracks healthcare and health insurance for the actuarial and consulting firm Milliman, told Healthcare Finance News, “It’s a very, very big shift from the way dental insurance is currently sold. For the first time, there’s a need for pediatric-only plans. State and federal governments still need to decide benefit levels and cost structures for stand-alone dental plans and medical-dental packages, in and outside of the exchanges.”

Many states have yet to figure out whether or not they will offer exchanges and the details of changes to insurance plan offerings.

There is still a lot of confusion about how the Affordable Care Act will be implemented.

Part of the confusion stems around whether or not health insurers will be able to offer medical plans without pediatric dental plans for individuals and small groups, and through the exchanges.

There is also concern that children will have duplicate dental insurance coverage, or families who have separate dental plans will be forced to have their pediatric dental plan changed to fall under their health insurance plan.

This could mean being forced to change dentists, which is something many parents and dentists alike will not be happy about.

“Another uncertainty comes from ACA rules on cost sharing limits for essential health benefits. Hypothetically, if someone has a medical plan for themselves and his or her child, and has a separate dental plan for the child, somehow the two insurance companies have to co-administer cost sharing limits–a problem without easy solutions.” Fontana advised Healthcare Finance News. “If you’re going to administer that, you would have to have claims accumulators going on the medical side and claims accumulators on the dental side that would have to talk to each other. For that to happen in reality, it’s just not a pragmatic solution.”

ADA members are increasingly concerned about the effects the ACA will have on their dental practices in 2014.

What are your thoughts about dental coverage in the Affordable Care Act? How do you think it will affect your dental practice? Let us know in the comments!

For more on this story see: Dental Insurers Eye 2014, Await Regulatory Guidance

Dentist Believes Dental Insurance is Wonderful (video)

Dentist Believes Dental Insurance is Wonderful (video)The recent U.S. Supreme Court’s 5-4 ruling on the Affordable Care Act has brought dental insurance coverage back into news headlines with approximately one out of every two Americans living without dental insurance.

By now it’s conventional wisdom that the American healthcare system is somewhat broken and most dentists think that dental insurance is at least as broken as medical insurance.

The Wealthy Dentist conducted a survey of dentists asking if dental insurance is just as broken as medical insurance.

Asked one dentist respondent, “At $1,000 per year in benefits, sometimes hardly paying for one tooth, how can you even call it insurance?”

But another dentist disagreed, “Dental insurance is wonderful. People who would never attend the dentist now have good care. The fact that some dentists charge more than the plans pay is their problem. I make my living from dental insurance.”

To hear more of what dentists had to say about dental insurance, Click on Play to watch the following video —

What are your thoughts on dental insurance?  Friend or foe?

Is Lack of Dental Insurance Driving More Patients to the ER?

Is Lack of Dental Insurance Driving More Patients to the ER?Do more people need access to dental insurance?

Uninsured Americans are turning to emergency rooms nationwide to manage the pain from dental problems, according to a 2010 Health Resources and Services Administration report.

The same report reveals that dental emergencies make up between 1.3 percent and 2.7 percent of all ER visits.

USAToday reports the reason is a lack of dental coverage for under-insured and uninsured patients as emergency rooms are treating toothaches, tooth abscesses and other dental care emergencies.

Although that number might seem like only a small percentage, Alan Sorkey, a Louisiana emergency physician, pointed out to USAToday that he treated 226 of the 6,336 patients for toothaches last year.

These dental care-related ER visits create higher costs for taxpayers because many of these dental patients return to the ER two or more times per dental problem to manage their symptoms, according to the ADA. And, while the Affordable Care Act addresses dental care for children on Medicaid, the requirement doesn’t exist for adults, ADA spokesman Robert Raible told USAToday.

The ADA is currently working with the Centers for Disease Control and Prevention to devise an approach to get “broader and deeper numbers and look at key indicators for solutions,” ADA President William Calnon said.

What are your thoughts on this growing dental insurance issue?

For more: Lack of dental coverage sends patients to ER for pain


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