Dentist often ask for recommendations on how many insurance companies they should join. This is the most crucial question to ask after deciding to accept insurance. For the most part, the answer depends on your goals as a provider. We believe one size does not fit all, so we often steer our clients to our Participation Optimization service so they can reach a more reasoned conclusion. However, a dentist considering the best strategy should consider the most important thing in the world of dental insurance today: the fact that employers change dental insurance plans often.

Most patients are insured through their employers. Dental insurance is a great benefit, but employers are not loyal to insurance companies and often switch them annually. This switch occurs because the insurance companies are always looking to offer employers competitive rates to get their business. The drive to seek competitive benefit rates has become stronger with the increasing employer costs under the Affordable Care Act. In regards to dental benefits this has manifested in two ways. First, employers change insurance companies to reduce their out-of-pocket cost or they change the plan offering from PPO to DHMO.

Generally speaking, there are 3 different types of dentists “taking” insurance.

First, there is the out-of-network dentist that sees patients with insurance, charges them full fee, expects payment at time of service and either has the patient send (or kindly offers to send) the claim. Once the claim is sent, the patient is refunded whatever insurance pays (if anything). This type of dentist either lives in an affluent area or has a large patient base developed over a number of years. The problem with this strategy is attracting new patients. This is because patients are mostly making provider choices for insurance and financial reasons. Consider how many times a patient calls your office not only asking whether you are in network, but also what the anticipated cost will be.

The second type of dentist is the dentist that signs up for a couple selective plans. These dentists focus on accepting only those plans that pay good fees, pay claims quickly or both. The most common insurance companies here are Delta Dental Premier and Metlife. Delta Dental Premier pays the best for in-network providers and Metlife usually pay the fastest. This strategy will bring a few more patients. However, it does not consider the fact that there is not many enrollees in Premier plans (as they are more expensive for the employer and/or subscriber) and because employers frequently change plans. Thus, it differs little from being out-of-network and may alienate existing patients over time. Further, plan selection based on how much they pay (or how quickly they pay) does not take into account whether taking the plan is good for the area in question. For example, why take Metlife in an area where the dominant employer offers Guardian?

The third type of dentist is the type that is in-network with all the major national networks as well as a few regional network players. This dentist not only sees more patients, but is also insulated from the effects of employers changing dental plans and existing patients changing employers. It is the most profitable and most flexible enrollment strategy to help for a provider looking to grow a profitable practice in these insurance-dominated times.