Problems & Solutions

Here are some problems we have encountered over the years concerning the dental insurance industry. Do any of these look familiar?

Problem:	Write-Offs increasing.
Solution:	Find the best mix of profitable dental plans for your specific office by determining the precise profit or loss for each plan in your area.

Problem:	Relying on dental plan write-off percentage for specific procedures to determine which plans to contract with.
Solution:	The reason you should not base your decisions on this is because write-offs tell you what you are paid but do not show if you are profitable. For example, if you charge $100 and write-off 50%, you are paid $50. If it costs you $25 to do the procedure, you’ve made money. If it costs you $75, you paid to do the work. The key is to find the cost for each procedure relative to what you are paid.

Problem:	Dealing with dental insurances is overwhelming to you and your staff.
Solution:	We provide services which help you deal with the problems you encounter with dental insurances.

Problem:	Dental insurances are not going anywhere. They have billions of dollars to fine tune their operations.
Solution:	Nailing down the precise profit or loss for each dental plan allows you to optimize your Take Home Pay.

Problem:	You feel you are losing control over your practice.
Solution:	Arming yourself with accurate financial numbers puts you back in control.

Problem:	Not knowing which dental plans to contract with when beginning or purchasing a practice or adding an associate.
Solution:	Understanding that one dental insurance may be profitable for an established dentist while being unprofitable for a new dentist or vice versa.

Problem:	Choosing dental plans based on what their colleagues recommend. This graph illustrates how widely the profitability of dental plans varies from one dentist to the next.
Solution:	There are several variables, such as overhead, procedures performed etc. that contribute to the profitability of each practice. Knowing how each of these variables plays a part is crucial to determining how your mix of dental plans would fall on this graph.

Problem:	Dental insurances keep money they would pay you if your fees are below their UCR.
Solution:	Review fees for all procedures against the fees of each dental plan to determine which fees could be raised.

Problem:	Not having an In-House Office Membership Plan.
Solution:	Develop a correctly priced office plan which is profitable and incentivizes long term patients.

Problem:	Not having the time or knowing how to negotiate with dental plans for higher fees.
Solution:	Getting help with negotiating is important because the difference between fee schedules under the same dental plan can be as high as $150 per crown and getting assistance.

Problem:	Not knowing the profit or loss of each procedure with your own fees and each dental plan.
Solution:	Calculate these figures based on all fee schedules including those you don’t currently contract with.

Problem:	A large percentage of patients on unprofitable dental plans.
Solution:	Targeting those patients for your profitable Office Membership Plan.

Problem:	The difference in what dental plans pay can vary by over $100 for the same procedure.
Solution:	Analyze your top 30-40 procedures by weighted average for each dental plan.

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