Is your practice dependent or independent of insurance, and what exactly does that mean. In the last five to ten years the definitions have changed.
Five to Ten years ago:
- Insurance Dependent: Contract provider for insurance PPO’s and some Capitation plans.
- Insurance Independent: Will file the insurance but not a provider for any insurance company.
Today:
- Insurance Dependant: Practice treatment plans according to the insurance provider.
- Insurance Independent: Practice treatment plans according to the best treatment for the patient, regardless of their insurance.
Patients have been indoctrinated to choose their health care providers from their insurance plan lists by the medical industry. Now the first place they look when picking a dentist is their insurance plan. This means that more and more dentists are accepting PPO’s. So what does that mean to the dental office? We have had to become very articulate when presenting the patients insurance plans so we can give them a proper treatment plan. In today’s economy that detailed presentation has become essential. However, it does not mean you need to lower your standard of care!!!! How many times have you heard the front desk say that you cannot do a Panorex because the patient has had one in the last 3-5 years? Does this mean that you cannot actually take the pan? OF COURSE NOT. If a pan is indicated for the patient, then it is the patients choice not the insurance company’s. The insured may have to pay out of pocket, but when educated properly most patients will understand the need and allow the panorex to be taken. Unfortunately, one of the greatest duties of the dental practice today is to educate the patient regarding the benefits offered (and not offered) by their insurance coverage. Is it fair for the patient to accept a less than desirable procedure (such as a 3 unit bridge) when an implant would provide a much better outcome? Treatment Presentation becomes important to give the patient the proper choices, not just the choices the insurance company will pay for.
Treatment plan as if your patient is a family member without insurance not as if the insurance company is running your practice. Most patients will choose the treatment plan you think is in their best interest if given the proper education and explanation.
