Amy Dukoff
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 HOULD
YOU have your practice participate in insurance plans? That is the
question. To answer it, let’s first consider the types of insurance
plan that are available.
Insurers generally offer two types of dental plan:
“open panel” plans and “closed panel plans.” Both offer the insured patient
a “panel” of dentists to choose from. With some limitations, open panel
plans welcome any dentist who chooses to participate in the plan. Closed
panel plans, in contrast, accept only dentists who have been approved by
the insurance company.
In a closed panel plan, the insurance company typically
negotiates a contract with the dentists. The dentist agrees to discount
fees in exchange for receiving patient referrals from the insurance company.
Why would you want to agree to lower your fees? The tradeoff for lower
fees is the potential of getting referrals as a result of being on the
company’s closed panel.
Should your practice enroll in some insurance panels
or none or work with them and their patients for a mixed payment?
It’s not easy for the practitioner to decide what is right. In the
abstract, it may seem easy to form an ideal opinion, but what makes sense
from a practical business point of view can be different. The insurance
question can be different for different practices depending on their stage
in development.
Taking insurance cam be important for some practitioners
who are beginning to establish their practices. First of all, it
can fill up “holes” on their schedules to keep them producing revenue rather
than being idle. If you are producing, you can feel that even a lower
fee is a contribution to overhead, since otherwise you would be not generating
any income. Second, being included on an insurance panel is a source
of new patients. Many people prefer to pick a dentist on the plan
if they are new to an area, don’t like their family dentist, or want someone
near their job. Third, being listed and accepting insurance patients
can help a practice temper outside economic situations that may affect
an area. If a person has a set amount of dental insurance to use
every year, he or she will tend to want to use that amount each year despite
general outside economic conditions or holiday time demands. Lastly,
insurance can play a role in the practice financially as a basis from which
to grow.
The decision to accept insurance need not be forever.
When one feels overwhelmed by too many patients who pay with their insurance,
it may be the time to withdraw from some or all of the insurance plans.
Once one builds a relationship with a patient, many times they will stay
with you as part of your practice whether you take insurance or not.
Most patients find it hard to leave you once they have developed a relationship
of trust. Also, patients will stay with you as they change jobs and
insurers and help you build your practice as your patient population increases.
Insurance can be helpful for a practitioner, but it doesn’t have to be
a long-lasting commitment.
April - June 2006
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The
decision to accept insurance need not be forever.
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