How 5 dentists want to see the insurance reimbursement process improved

Increasing reimbursement payouts to keep up with inflation is dentists' best solution to improve the process.

Here, five dentists answered the question: How could the insurance reimbursement process improve or be better for dentists?

Note: Responses have been lightly edited for clarity and length.

Joseph Boyle, DDS. General Dentist (San Antonio): The obvious way for insurance reimbursement to improve would be to increase the payouts on their fee schedule to keep up with cost of living and inflation. Costs of goods of course have risen, but a dental office can shop around for better pricing. One of the biggest rising costs in my practice is the rent on my office. Shopping around for better rent prices every few years is not realistic. The increase in CPI is far greater than the increase in insurance reimbursement, so each office has to figure out a way to recoup that money to stay solvent. My approach to insurance companies is to play the game: I eval each company's fees and rules and then come up with a strategy to take advantage of any opportunities to benefit my patients and my practice. When they change the rules, I change my strategy.  

Michael Davis, DMD. Smiles of Santa Fe (N.M.): The abusive conduct of the dental insurance industry has passed a breaking point. This includes leasing out provider networks to other carriers without the advice and consent of the actual providers and payments in credit card form, which require a 1 percent to 3 percent processing fee to the provider. With all the above abuses, I haven't even discussed the paltry remuneration listed with insurance industry fee schedules. These figures are often something from 20 to 25 years in the past. Numbers not only have not kept up with inflation but are frequently below the cost to render a service properly and to standard of care. As a result, numbers of dental practices are dropping their standing as "preferred providers." Others have unfortunately taken up the grift of bait-and-switch. Customers are quickly upsold on treatments not necessary or which generate maximal out-of-pocket expense to the public. At this point, elements of the dental insurance industry are fully complicit with a rapid degradation in dental healthcare. 

Nora Donatelli, DDS. General Dentist (Wheeling, Ill.): When all my expenses of doing business have increased, I can no longer justify being part of networks that are intentionally mocking my profession. Some reimbursements don't even cover my lab bill. I've been in this field over 30 years now, and insurance maximums have barely increased past $1,000 per year. Enough is enough. I can make more money being out of network and working less than being part of their networks. 

Jim Forni, DDS. General Dentist (Santa Rosa, Calif.): Insurance reimbursement has changed significantly the past few years. I now employ another staff member solely to deal with insurance. They simply hold claims until we call on them. Once we call, they release the reimbursement. Almost always with no cause to hold. 

Abrahim SeToodeh, DDS. Peoria Dental Center (Peoria, Ariz.): The reimbursement fees are not catching up with the inflation nor with the staff members pay increases. We had to increase our hygiene pay by 40 percent and other staff by almost 20 percent just to keep him happy. The lab and supplies cost have all gone up by almost 5 percent.

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