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Decrease Your Dental Practice’s Dependence on Insurance: a Safer route to Non-Par

January 8, 2024

Contributors: Curt Nurenberg, CHBC

You’ve most likely dealt with at least one of the three most significant challenges private practice owners faced in 2023: increasing overhead, difficulties in recruiting or retaining staff, and the complexities of patient scheduling. Ready to set up your patients and practice for a successful 2024? Two members of our Dental Practice Management advisory team, Danielle Ambrozy and Curt Nurenberg, suggest addressing this one first: building a step-by-step strategy to reduce your practice’s reliance on insurance. 

The Dominance of Insurance Companies 

From treatment acceptance based on insurance coverage to differing reimbursement levels associated with provider status, the dental insurance system might feel like a game you’re never going to win. The multitude of insurance providers — and their varying reimbursement ranges — make operating your practice exceptionally complicated. But the one thing all insurance providers seem to have in common is that no matter how varied their reimbursement levels, most have been stagnating for over a decade. This adds to the irritation you already feel about rising overhead costs and restricted practice hours due to staffing levels. You’re not the only one frustrated – your patients are experiencing scheduling difficulties and are concerned about their timely access to care.  

Strategic Solutions 

As much as you may want to cut the network cord impulsively, we recommend a well-informed, methodical, and highly strategic approach. Start by identifying your top 20 most common procedures and conducting a detailed fee comparison of each insurance carrier’s reimbursement levels. Take time, too, to analyze the number of patients associated with each insurance provider, making sure your active patient count is accurate, and to make data-driven decisions regarding continued participation with that insurance.

Engage Your Team

Include your team in the decision-making process. Ask your team if they would be willing to work without raises or additional benefits for an extended period, to illuminate for them the dilemma practice owners are experiencing. This comparison encourages your team to put themselves in your shoes, while demonstrating your commitment to transparency and alignment of the team with the overall vision. Make sure they understand the inextricable relationship between reimbursement and their total compensation package. You want to retain your team members and reward their performance with compensation and benefits commensurate with their contributions to the practice’s success.  

Additionally, talk to a few trusted patients and get their feedback. Let them know that you will continue to file claims on their behalf; however, they will be responsible for payment at the time of service, and their insurance provider will reimburse them directly based on the amount covered for the services rendered. Their input will help you see more of the “patient perspective” and guide you as you respond to them. 

Enhancing Patient Experience and Introducing In-House Loyalty Programs 

To address patient concerns about changes in financial structure, many practices we work with are realizing success by implementing in-house programs for their patients of record. Providing your valued patients with consideration or bundled services encourages their loyalty, despite increased out-of-pocket expenditures.

Navigating the Transition 

Reducing your practice’s reliance on insurance after years of maintaining the status quo will be challenging. But preparing for the emotional and financial fluctuations can make the transition significantly easier for all involved.  

You can prepare by: 

  • Writing down your goals.  
  • Sharing your story with patients, explaining why you are making changes and committing to transparent communication with them throughout the process. 
  • Calculating the immediate financial impact on your practice. 
  • Expecting and having plans in place to best manage uneasy patients, reduction in your chair time, etc. 
  • Writing a Q&A so patients can see how the changes will impact them; likewise, be sure team members also understand and can explain or elaborate as needed.  
  • Scripting and practice will be vital! Empower and equip your team to answer patient inquiries completely, correctly, and with conviction. 

Despite the initial challenges, you will find that going non-par with insurance providers may pay priceless dividends in the long term — reduced physical strain on practitioners, increased time and focus on patient care, the ability to determine the right treatment for each patient, and much more. We have collaborated with many practice owners whose biggest regret was not initiating this process earlier. 

Words of Guidance

If your practice is considering a change, don’t waste time worrying about the potential difficulties; instead, focus on finding and evaluating the necessary facts that will help you set the best course for your practice. Initiate the due diligence process, involve your team, and seek expert advice. If you have questions or would like to consult with an industry professional who has assisted private practices as they navigate the insurance landscape, learn more about how Rehmann supports the healthcare at https://www.rehmann.com/industries/healthcare/