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55% of Responding Dentists Have Partially or Fully Stopped Taking Insurance

August 1st, 2008 · No Comments

At the WealthyDentist.com, a recent survey reveals that over half of the dentists who responded have completely or partially stopped accepting dental insurance. The 44% who claim that they only partially work with insurance companies may mean that they are not in network with any insurance company, but they will file claims as a courtesy. They may or may not accept the patient’s copay or deductible.

For some dentists, rejecting insurance would put the kiss of death on their practice. Particularly in rural areas, general dentists must accept insurance if they are to sustain a business. However, in more affluent areas, patients may have the liquid funds to pay up front fees or to opt out of dental insurance altogether. Furthermore, cosmetics are not covered by insurance.

A little lesson…

Fee for service: These dentists may file claims, but the patient is responsible for paying the entire balance due when services are rendered. Reimbursement from the insurance company will go directly to the patient.

Accept assignment: These dentists may not be in network with an insurance company, but they will accept the patient’s copay or deductible based on an estimate of what the insurance will pay. Any positive or negative balance is worked out after the insurance company cuts a check to the dentist.

In network: These dentists are providers for insurance companies and perform work at a dictated, discounted rate.

Out of network: This means that a dentist will accept a patient’s insurance policy if the insurance company allows the patient to choose his or her dentist. The dentist may or may not accept the copay or deductible. Some insurance companies will not allow the dentist to accept assignment.

Many experts recommend using third party financing instead of offering in-house payment plans. To learn more about patient financing, visit these websites:

CareCredit Chase Advance CapitalOne Springstone Wells Fargo

Tags: Administrative