If you’re a dentist or a dental office manager, you’ve probably wrestled with the question, “Does accepting insurance help your dental practice?” There is no simple answer, but your choice will have a major impact on your practice for years to come.
In making your decision, remember that your dental practice is a business. And like all businesses, there are activities that you must be proficient in to be successful. Below are three important business activities and how they are affected by accepting dental insurance.
After you’ve hung the molar-shaped sign in front of your office, you can’t sit back and wait for patients to stampede your front door. In today’s competitive market, that’s not likely to happen, so you need to come up with a robust marketing plan and budget. That’s right, marketing and advertising cost time and money. And that’s where accepting insurance has a huge advantage. By accepting insurance, you open your practice to all patients and not primarily those without insurance.
Further, by joining a dental provider network, you get “free advertising” on the insurance plan’s provider directory.
Before deciding to market only to patients who do not have insurance or to those who have insurance, but are willing to do business with you anyway, you might consider the following statistics:
- At the end of 2014, approximately 205 million Americans (64%) had dental insurance.
- Studies show that 44% of people were not seeing the dentist because they don’t have dental insurance and are simply unable to afford the treatments.
The point is that accepting insurance expands your market of prospective customers and is a powerful way to grow your practice and keep patients in your procedure chair.
Service to dental patients doesn’t begin when you say, “Open wide,” or end when you say, “Rinse and spit.” Dental patients are customers seeking the best service for their money. For many, that service includes:
- Accepting their insurance
- Communicating in advance what is covered
- Providing treatment plans
- Filing claims
The above services might seem like routine tasks to a dental professional, but to the consumer, they can be overwhelming. By understanding patients’ insurance and what it covers, you are providing an invaluable service to them. Dental practices that are proficient at these value-added services typically have a competitive advantage over practices that give them short shrift.
Billing and Accounting
Cash flow is the lifeblood of all businesses. Dental insurance companies understand this and have established administrative systems that make it more efficient for providers to accept patients who are covered by their insurance. Some of those services are:
- Timely claims payment
- Easy administration
- Online web portal to verify eligibility and plan benefits
The Challenges of Accepting Insurance
The discussion about accepting insurance usually boils down to the challenges of dealing with discounted fees for covered services. Those challenges include:
- Accepting the insurance plans’ fees as payment-in-full and not balance-billing patients for covered services (if you are an in-network provider).
- Explaining to patients why their plan doesn’t cover a procedure and “selling” them on getting the procedure and paying out of pocket.
- Determining whether your office can provide the covered services for the discounted fees and make enough money to pay for office overhead and make a profit.
Meeting and overcoming these challenges are what separates the great practices from those that are merely getting by. There are myriad resources that teach how to deal with these challenges, from time management to delivering exemplary customer service. And you might take small comfort in knowing that all dental practices and most other businesses face the same challenges daily.
Choosing Your Strategy
The question about whether accepting insurance hurts or harms your practice elicits strategies for either choice. But they only offer strategies and not a cure-all for the dilemma. In the end, it’s up to you to make your strategy work. However, when you consider that many Americans can get dental care because of their dental insurance, it’s a safe bet that accepting insurance is a winning strategy.