Why Dental Insurance Reimbursement is on the Decline

After yesterday’s news that healthcare premiums may increase up to 22%, dental professionals are bracing themselves for what may happen with dental insurance in the coming year. Although it’s impossible to predict exactly what the future holds, it’s clear that big changes to benefits tend to rock the industry.

Below, we’ll evaluate the current state of the dental industry, and offer a few different approaches for helping your patients navigate any future changes to their benefits.

The Current State of Dental Insurance: Reimbursement on the Decline

There are a few reasons that dental benefits are depleting and reimbursements are on the decline:

  • Employers are paying more for less coverage
  • Employees have higher contributions for dental plans
  • Government mandated health insurance have increased the cost of all health care
  • Employers are reducing plan coverages in an attempt to save money on premiums

Patients are now stating that their number one reason for not visiting a dentist is they can’t afford it; those without dental insurance are the least likely to visit the dentist. This matter is further complicated by other issues:

  • Having insurance doesn’t mean it is used: with expenses going up, even patients with insurance are
    less likely to have dental work done because they don’t want to deal with the co-pay
  • Annual maximum coverage is going down and insurance is taking longer to pay
  • The changes in dental benefits have made consumers more aware and more cost-conscious. More patients are price shopping for dental care as a result.
  • The push to PPO plans is driven by employers seeking lower cost benefits to provide to employees.
    With such a high focus on medical benefits, employees often don’t even realize their dental benefits are
    being reduced to save money to offset increases in medical insurance costs
  • Patients don’t know how to maximize their benefits, and therefore those benefits go unused

How You Can Help Your Patients Navigate their Dental Benefits

Have a look at the following tips to help your patients understand and use their full dental benefits and learn how to pay for their treatment costs.

  • Increase patients’ awareness of the decline in dental benefits, but remain reassuring that your practice will help them utilize every possible payment option available, including maximizing current benefits and utilizing payment plans.
  • Have conversations with patients about the cost of treatment:
    • Avoid language such as, “We’ll have to check with your insurance” or “Your insurance only covers part of the cost.” Instead, focus on payment options for any balance remaining after insurance.
    • Educate your patients on the cost of treatment now vs. later: i.e., $100 for fillings now vs. $1000s for corrective procedures in the future, such as root canals, crowns, and extractions
  • Offer in-office payment plans:
    • Help set up payment plans for entire dental costs up front, and deduct the insurance payments from the amount owed.
    • Accept 3rd party payment options such as CareCredit or Lending Club
    • Create in-office insurance plans
  • Implement procedures covered by medical benefits, i.e, sleep apnea – cross coding ICD-10.

Helping Patients Understand Dental Insurance Will Benefit Your Practice

Helping your patients understand their dental insurance, along with maximizing their benefits, is an excellent way to enhance the patient experience. And enhancing your patients’ experience is more than just a best practice; it actually benefits your practice in the long-term.

A happy patient is a loyal patient — and an excellent referral source.

To find out more about helping your patients understand their dental insurance, maximize their benefits, and increase patients’ overall satisfaction with your practice, contact us today.