Why I have gripes with dental insurance companies

[DrJeff]

The following is a portion of an article that appeared in one of the "dental rags" that will show up in your practice mailbox once your on either the ADA/ASDA or the AGD's mailling lists. I was reading an article in the March 2004 issue of Dentist's Money Digest entitled "Recognize the Benefits Insurers Provide" written by Karen A Whitesel who is corporate Vice Pres of professiional relations and product development for United Concordia Comopanies Inc(a national dental insurer){Basically I was passing the time as I was trying to get my 10 week old daughter to fall asleep}. To paraphrase the first 3/4ths of the article "dental insurance = good". Now, the last 2 paragraphs:

"Paperwork aside, the fundamental commodity requested from dentists is a reduction in the price charged for services offered to the insurer's patients. This is referred to as a discount. Discounts vary by insurer, dentist location, and the types of benefit plan. Dentists are asked to accept price reductions from 5% to 30%, or even 40%, depending on the insurer's fee schedule. The balance between the amount of the discountand the gain in business development and practice performance is at the crux of the dentist-dental insurer partnership, and should be accepted as good business for both parties.
With 52% of all employers offering dental insurance, it's clear that the dental insurance industry is here to stay. And when dental insurers thrive, dentists propser."

Let's see, the dental insurance companies are charging their "clients" more (my father is a senior VP of human resources for a Fortune 500 company and deals with the medical/dental benefits programs and complains to me each year that dental insurance rates are going up). They don't raise their yearly maximums at all, even though they know are fees are going up, and they want us to accept lower fees while their corporate profits soar each year

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[groundhog]

Health insurance at one time was a noble calling in which to work. It was one of the best examples of how the private sector could do a public good better than a governmental agency. It worked because the health insurance companies were lean outfits, orientated themselves towards a long term business strategy , did not try to divide the population up into different risk categories, and were not in business to become the tail wagging the dog by squeezing the healthcare providers in order to put more dollars in their pockets. Sadly, those days are gone

 

[drPheta]

This has always pissed me off about insurance. What I want to know is why the gov't and ADA, ASDA, and all the other local dental communities/orgs don't have a say in what the insurance can and can't charge. I know it's hard to get a large voice heard, but isn't there a way for all dentists to be able to say, "No, we don't want to deal with insurance agencies who raise their premiums but lower their maximum fees?"

It's not unethical, so to speak, considering this fight agains the agencies is for both the public benefit with regard to their costs and the health care benefit with regard to providing quality care AND covering the cost of the procedures/materials/facilites/equipment/etc. It makes absolutely no sense for insurance to be around when they charge ridiculous premiums that don't cover what it really costs for what they are insuring.

Ever since I've started buying my car insurance myself, I've hated insurance companies. All of them. While there are those who provide reasonable service for their cost, they all are in this game to make a quick buck while many professionals are really out there doing the noble deed and getting left with the raw end of the deal.

Maybe i'm wrong, but this is how I've always envisioned it.

 

[PERFECT3435]

did you guys forget the govt medical program?


i feel that they are worse than the insurance companies when it comes to profit or cost prevention.

i almost had a heart attack last week when we got the medical paper back for some patient. we requested for root canals on 3 teesth (8, 9, 10). medical responded back saying they don't wanna cover it. yep, they want us to extract all three teeth and make an upper denture for the patient.


now that really pisses me off. i know they are trying to prevent future costs, but it is totally unfair that the patient should let them extract three strong teeth so that our state can save the $$.


GO AND FIX THAT Mr. ARNOLD

 

[sxr71]

Originally posted by PERFECT3435
did you guys forget the govt medical program?


i feel that they are worse than the insurance companies when it comes to profit or cost prevention.

i almost had a heart attack last week when we got the medical paper back for some patient. we requested for root canals on 3 teesth (8, 9, 10). medical responded back saying they don't wanna cover it. yep, they want us to extract all three teeth and make an upper denture for the patient.


now that really pisses me off. i know they are trying to prevent future costs, but it is totally unfair that the patient should let them extract three strong teeth so that our state can save the $$.


GO AND FIX THAT Mr. ARNOLD

What healthy upper teeth did this patient have?