A California dental practice recently left Delta Dental's provider network to avoid losing money on services.
Brian Fong, DMD, of Dental Center of Atherton (Calif.), recently spoke with Becker's about how his practice has been dealing with payer reimbursements.
Editor's note: This response was lightly edited for clarity and length.
Question: How are payer reimbursements affecting your practice?
Dr. Brian Fong: We recently dropped Delta Dental because our latest fee increase was back in 2011. With the rising cost of labor, utilities, rent and materials, our margins for many of those in-network procedures went to negative where we were providing hygiene appointments at a loss when looking at revenue versus cost.
The interesting thing we discovered is that some employers are providing plans with really competitive out-of-network Delta Dental coverage. Patients would never know this unless they actually saw an out-of-network provider though. So we decided to preauthorize our Delta Dental patients prior to their appointments so we could be as transparent as possible.
Many of our patients who are part of large tech companies like Google, Apple, Nvidia, EA, Genentech, Kaiser, Meta, etc., have varying levels of out-of-network Delta Dental reimbursement. We actually told patients to let their HR departments know that the plans they selected for their employees was not as good and would likely be cost prohibitive for some to see the providers they preferred to see if they did drop Delta Dental, opting instead for providers who likely did not provide the same level of patient care or invest in the latest technology to provide more accurate and predictable outcomes.
Since dropping Delta Dental, we have definitely seen a decrease in overall number of patients scheduled, but revenue still remains steady. I would estimate [that] out of 1,000 Delta patients, we were probably able to retain about 50% to 60% of them. Most of my colleagues are electing to go out of network, however.