Should I take dental insurance or not? Part 2

dental insurance

Last week we started this topic related to what’s the best avenue for most practice when it comes to fee for service dentistry and a client story was being shared to what it takes related to being 100% fee for service and dental insurance.

In a moment, we’ll finish with the rest of his story. FYI – If you want more of a background in the beliefs and action steps that this doctor has been taking during the past five years you’ll find them here.

When I look at skill sets clinically and administratively and what makes sense for a practice related to payment schemes here’s how the profession breaks out from my viewpoint and whether they need to accept dental insurance in the practice or not.

30% need to be 100% dental insurance committed (meaning 0% fee for service) because they lack the traits, behaviors, inter-personal skills, and beliefs to operate even a mixed fee for service professional practice much less one that is completely outside the insurance system. While this might seem harsh, when I look at our physician cousins (and I interact with a fair number of them), 95% of MDs need/deserve to be inside an insurance system as they truly cannot provide legitimate reasons why they deserve to be paid anything more than an insurance contract dictated fee. As compared to physicians, dentistry is doing a much better job in this respect.

50-65% are capable of having a mixed practice with an insurance component and some fee for service aspect. Roughly half of the practices will have a niche service component to them. Any doctor that believes they can be in this 50-65% can benefit from being part of our membership.

Finally, 10-15% will be capable of having a 100% fee for service independent practice. Doctors in this 10-15% are routinely the ones that show up for this program.

Needless to say, the doc sharing his story is in this 10-15%.

Now…. let’s continue on with his story.

“Staying out of network when my son graduated from dental school was a huge decision. I spent a lot of time going through the options. In the end, I personally believe for me that I cannot have a hybrid practice. The team would be constantly mixed up on how to interact with patients. You don’t take a top Nordstom employee and send them to work at Nordstom’s Rack outlet every other day. It would drive them crazy and they wouldn’t be good at either job. Our mission is to have XXX Dentistry a brand and not about just me. This creates a practice with much more value than one that becomes a PPO practice when the “top doc” retires…

So from day one, we created a situation where patients are (hopefully) happy to pay the same fee for their treatment regardless of being me or my son. The patient knows that he is the guy that does certain procedures. His new patients see him and accept his treatment plan just the same as me. This did not happen by chance and all the experts (from the dental world – not the rest of the world) told me that he would HAVE to come in joining PPO’s to get him busy. Additionally, I chose not to add children to the practice – again, against the so called experts opinion – because that would have changed the atmosphere of our adult practice.”

“After two years we have proven them wrong (we should reach 3.5 million production and collections this year)  But then again, XXXX is on the “XXXX Dentistry residency” and has almost 500 CE hours after two years. Trying to duplicate me as soon as possible. In fact he already qualifies for his FAGD! He is going to take the test, however he can’t receive the FAGD because he has not been out of school long enough. He’s almost through the continuum, He’s done multiple hands-on courses with David Hornbrook, He’s been through the Endo courses in Santa Barbara with Ruddle, he’s on his way through the AACD accreditation and has completed a two year ortho continuum where he is trained 2 days every month – so he is doing full banded and bonded ortho better than a new orthodontist graduating – because he understands diagnosis and treatment planning.

Additionally, I am located in a fairly upscale part of XXXX. Not XXXX Beach, but an affluent area. Kind of analogous to Westwood or Century City compared to Beverly Hills.  I have a beautiful office built 3 years ago. Nobody is going to come to my office thinking we will be low priced. I believe you must be “all in” or you will not succeed in a private pay dental environment.

I feel like we could be doing 5 million if I had the time and energy to hire and train a full time marketing/outreach/ person and additional treatment coordinator. We would go two days a week with my XXXX trained periodontist (he is one day a week right now) All that will come eventually…..”

Doctors in the 50-65% who want a better blended practice or those aiming for the 10-15% wanting a 100% fee for service practice routinely embark in the this program as part of achieving their goals.