By Jill Shue

Over the last several months, our team has had discussions with owners over a common theme: dropping insurances. Why is this and is it the right decision?

Since offices were shut down for upwards of 8 weeks beginning in March, dentists experienced a demand for their services and an overabundance of patients waiting to get in for their next appointments. Podcasts, social media, talks with colleagues, all lead to one common conclusion: ?we need to drop insurances while the demand is hot! Between the added time for procedures (and time between procedures), additional costs for PPE, and patients pounding down our doors, this seemed like a reasonable time to band together and take back our practices, both in the way we treat patients and in our hard-earned money.

While going out of network may be the right decision for some offices, it may not be the best decision for your practice. Our team strongly encourages practices to thoroughly evaluate their decision. Some items to consider before pulling the trigger to becoming an out of network or fee for service practice:

1- Do your finances and practice retention/growth trends support your decision to drop insurance contracts? An in-depth financial review and practice trends are key in your decision making. What percentage of patients would be affected by this decision?

2-  Is this a whim decision or something you have contemplated for years on end? Abrupt decisions regarding future insurance relationships may backfire and cause a higher patient loss than anticipated or than can be afforded. If this is a decision you have been preparing for and you have that plan that is forever a thorn in your side, this may be a great time to review whether to continue that contract.

3-  Outside of COVID, has there been a waiting list to be seen, or is this a pent-up demand resulting from the shutdown? Due to the length of time waiting to be seen at their dental home, some patients may be calling around to see who can get them in sooner, which may give a false view on practice growth. The phones ringing continuously with patients waiting to be seen can feel overwhelming, but is this a temporary demand? If you look into your October/November schedules, does this trend continue, or do the holes in the scheduled return?

4- Is your team prepared? Providing your team with resources, training, and scripting in how to manage conversations regarding the network changes and re-educating your patients to not allow insurances to dictate their care is crucial in your success in going out of network. Preparing your team for this mindset shift will make the transition, for both your team and your patients, much smoother.

5- Consider implementing an in-house membership plan, if you haven’t already done so. Providing your patients with an alternative option to purchasing an insurance plan is a great way to introduce the change in your network status. This alternative option will show your patients the benefits of a membership plan without an outside party placing restrictions on their healthcare, while still providing them with savings.

Once it has been determined if the changes in network status are the right fit for your practice, have a plan before you send the termination letters. Prepare a slamming letter communicating the change to your patients (most contracts require you to notify your patients of the change) and start communicating the changes with your team.

Let our team of experts assist you in reviewing the financial status and trends within your practice and prepare your team for the coming changes successfully with minimal impact on your patient base.