“Do I have to?”
Although a pleasant dream, the thought of refusing to take dental insurance and becoming a totally fee-for-service practice strikes fear in the average dentist. Even though there are a significant number of dental practices that decline participation, most are compelled to sign up for multiple networks to increase new patient flow and/or minimize complaints from existing patients that expect you to be on their list of providers. At the very least, there is pressure to confirm benefits, file paperwork, and collect remaining balances after reimbursement from the insurance company. The reduced revenue, stress and time involved in managing the processes are hardly worth the contract fee received through most networks.
The grab to participate in multiple networks and attract more patients, costs the average practice thousands of dollars each year. To help understand how this happens in short terms, the insurance companies filter each claim through all the networks you have contracted then reimburses you through the lowest paying network with your name on it. As if that is not bad enough, this process also creates confusion between you and your patients making it impossible to provide accurate payment estimates.
Over 40 years ago, most dental insurance companies paid $1,000-$2000 maximum annual benefits per participant. At that time gas was $0.90 a gallon, stamps were $0.15 each, a dozen eggs were $0.50, and you could get a nice new car for under $7,000. Most everything cost a lot more today, however most participants still receive average dental benefits of $1,000-$2,000 per year! Compared to the value of a dollar today, that does not really amount to a lot, but many patients still teeter on a decision to accept treatment based on how much their insurance will pay and whether you will accept participation.
So, if you are going to participate, why not get paid as much as you possibly can without affecting the premiums paid by your patients, reduce the confusion of coverage and the chase to collect unpaid balances? You need someone on your side that knows the ins and outs of an industry that models their business to maximize profit by minimizing payment for covered treatment. Good news! There is a group that has done the work of negotiating the highest reimbursement schedule available to any dentist in America, Dental Advocacy Group. Dental Advocacy Group (DAG) was founded by a retired dentist and his daughter, a 35-year veteran of the insurance and healthcare industry. DAG was formed with the singular purpose of helping independent dentists be financially successful with their insurance contracts.
Dental Advocacy Group has created the highest reimbursement schedule available!
DAG formed it’s own PPO, the PFS Dental Network, which brings access to over 40 market leading insurance plans, with names like Aetna, Ameritas, GEHA, Guardian, MetLife and United Healthcare. PFS offers a contracting solution that includes one contract, one credentialing application and one fee schedule that applies to all insurance plans covered by the program. In addition, the rates are 20-30% higher than what they would receive if they directly contracted with each insurance company and with a simpler administrative process.
It really does sound too good to be true, but do not let that hold you back from investing a small amount of time to see the exact impact participation would make to your practice. DAG will do a no-obligation analysis and pro forma of your current network(s) to show you what you would have generated in additional revenue based on your real data history but by being reimbursed at the preferred network fees. You have a lot to gain and nothing to lose. Here is what clients have said about Dental Advocacy Group.
I have been working with Dental Advocacy Group for just over three years now and could not be more pleased. In network providership allows for a razors edge margin for error and profitability. With that said, DAG is constantly working to negotiate fee schedules that allow maximum payment under the headings of a massive variety of PPO plans. Cornelia, Michael and their team take all the guess work out of credentialing and recredentialing that can be tedious to say the least. The fee schedules that are achieved are significantly greater than any I have been able to negotiate in the past on my own dealing with companies as a single practitioner. Whether you are in a 10 operatory, 2 doctor practice like mine, or a 3 op practice just beginning to swim in the PPO pool, constant fee negotiations are absolutely necessary. Without DAG I would not be able to achieve the results in PPO profitability that I now have. A Class A organization all around. I couldn’t be happier.
When our practice was looking for new ways to increase revenue, we hired a consultant that suggested we speak with Dental Advocacy Group regarding their program. We had tried to get fee increases from of our insurance companies and always hit a brick wall. Our fees were consistently being cut. When we met with DAG we were a little skeptical to say the least. We decided partner with DAG in hopes of seeing our revenue increase. Jaime, our account manager, has been wonderful in walking us through a somewhat complicated process. She is knowledgeable, well organized, patient and responds promptly to our questions. She kept track of our network participation status with the insurance companies while we waited for our fee schedules to switch over to the higher schedule. This process does take time, but we are already seeing significant changes in our reimbursements.