What 2 dentists want from payers in 2023

Increased transparency and reimbursement are what two dentists would like to see from insurance companies this year. 

Dental industry professionals have been at odds with payers in recent years because of stagnant reimbursement fees, case denials and more. Two dentists recently spoke with Becker's about what changes they would like to see from payers in 2023.

Editor's note: Responses were lightly edited for clarity and length.

Douglas Solow, DDS. Professor, Associate Dean of Clinical Affairs and Director of Faculty Practice at the University of Southern California Herman Ostrow School of Dentistry (Lost Angeles): I would like to see more transparency among payers in how [Usual, Customary and Reasonable] numbers used for determining benefits are determined. This is particularly important for PPOs or programs such as Delta Dental where the UCR becomes the maximum allowable charge and the dentist cannot balance the bill above that number. In California, this has become a major issue for dentists since Delta Dental just implemented a new fee structure that will result in a loss of income for most participating dentists.

Charles Schlesinger, DDS. Comfortable Dentistry 4U (Albuquerque, N.M.): I would say I am just looking for fair compensation for the work I do. I would like to see an end to downgrading reimbursements and fees which are commensurate to what they should be in 2023. This goes for all insurance companies across the board. I use the best materials and give a service which has a very standard of care. Also, as one of very few practitioners in my area that treat patients on state aid, it would be nice to be paid an amount that allows for profitability for my offices and will continue to allow me to treat these underserved patients. If things continue to trend the way they are now, I will be just another dentist who will withdraw from these plans ultimately leaving the patients with very few options.

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