Being out-of-network has allowed one dental practice to service patients without dealing with the stress that comes with working with insurers.
Rajdeep Randhawa, DDS, is the owner of Innovative Dentistry in Colts Neck, N.J. He recently spoke with Becker's about why his practice does not participate in insurance networks.
Editor's note: This response was lightly edited for clarity and length.
Question: How are payer reimbursements affecting your practice?
Dr. Rajdeep Randhawa: Payer reimbursements are becoming a major issue for in-network private practices and participating in-network DSOs that have a significantly large pool of insurance-directed dental patients, and every time millions of their claims are denied for outdated plan limitations, yearly maximums and all other types of plan dictations that they willingly sign on the dotted line with all different types of plan networks. Most of the insurance-paid procedures belong to the outdated "maximally invasive dentistry," with one of the least expensive dental procedures being dental extractions, triggering millions of teeth to be prematurely lost as patients opt for less expensive options when they cannot afford the much higher copays for dental procedures that can save teeth and restore them. Most of the minimally invasive dentistry and noninvasive options are not even provided to millions of insurance patients because they are considered cosmetic, or other reasons are given to deny the claims.
Payer reimbursements are not affecting our practice as we decided not to be entangled in the established predatory techniques of the insurance industry to entice you to become one of their participating providers. We have fun, enjoy our profession and give our patients the best services possible using the best and latest procedures and customized treatment planning for each patient, spending enough time to answer their concerns/questions as many of them are looking for a second, third or fifth opinion as their trust with earlier dentists has been damaged due to one reason or another. We give our patients treatment plans according to their needs, wants, concerns and affordability, without any reference to their outdated dental plans that pay for the least expensive options with a lot of limitations.
We tell the patients who call for appointments that we are out-of-network providers, and if they are looking for an in-network dentist, they have to call another practice. The freedom we and our patients have in not having any interference from third parties or payers is priceless. Once you get addicted to this noxious drug called insurance or payer reimbursements, then you are in trouble. All the undue stress that the insurance industry gives thousands of providers is one of the factors for burnout for dentists, dental managers and the rest of the dental teams during and after the COVID-19 onslaught.
The [American Dental Association] has already surrendered dentistry to the insurance industry for the last 70 years or more, and now the DSOs, in their rapid expansion spree, are doing the same thing without understanding that dental providers should not be exploited to a level of major burnout where a negative feedback loop is sent to future dental prospects, making the shortage of dental professionals long term and disruptive.