Tuesday, May 21, 2013

LIVE 
Why Dentists Are Frustrated With Insurance...
This month's panel members:
Curtis Marshall curtis@procorecpa.com
Ben ben.tuinei@gmail.com
Nicole nicoleclark805@gmail.com
Suhan (Swan) srojas@johnsonfamilydental.com


20 comments:

  1. Post Questions and Comments! We will respond to the Questions. Comments are to better this mastermind group to LOVE DENTISTRY :)

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  2. Does your group work with offices that have become non-contracted with all insurances?

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    1. 100% We are a Mastermind with all different-types of philosophy's. That is the reason why we encourage individuals to post. And we will also have new panel members, love to have you on in the future!

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    2. Brian, yes we work with all offices, regardless of whether they participate with insurance or not. What type of help do you need? ben.tuinei@gmail.com

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  3. Q: How would you describe the quality of advice we've had from some big lecturers regarding dental insurance? I have found much of it to be useless. All they tell us is how WE should "behave".

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    1. Check out the Insurance Fee Negotiating Video on ProCore's Youtube Chanel. http://www.youtube.com/watch?v=hxl1AO9ijjE Big lecturers in the industry are not sharing information like this. It's not about how you behave more than it should be about how to force insurance companies to behave.

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  4. I heard today from a dental repairman that many dentists devastated by Superstorm Sandy have walked away from their practices. Q:For added leverage in fee negotiations,is there a way to find out Which Insurance plans recently lost the most providers? Might they be more likely to raise their fees for you than lose another provider.
    ?

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    1. We have many clients in New Jersey that walked away from their offices but they all found jobs at dental practices nearby and made arrangements with colleagues to merge practices. Most of the dentist that closed their practices are still in New Jersey practicing at a different location. Regardless of how saturated a market is you can still negotiate. Our negotiating efforts started in Salt Lake City where there are as many dentists as there residents (so it seems) and 100% of the practices we've deal with in Salt Lake have had success in negotiating PPO reimbursements. The major piece of leverage we've used is the law. It's against restraint in trade (Anti-trust) for insurers to discriminate or be selective in offering higher fees to a few select offices. As a third party representative of many practices we saw what many doctors were getting paid and were surprised that some offices were getting paid 15 to 30% more than most of the offices in the area. When we reached out to insurance companies we referenced specific language in both state and federal law and did go as far as accusing insurers for violating anti-trust. To keep us quiet they offered us the same fee schedule as the other practices in the area that already had those higher fees. The good news for dentists nationwide is that you can negotiate fee schedule terms no matter where you practice.

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  5. During a case presentation a patient told me today, I am going back to my previous dentist because he never charged me anything.Some offices are voiding copayments. What should we do, this is disloyal competition.

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    1. It is also insurance fraud! The other dentist is taking insurance payment as full payment, that is the amount he/she should be billing to insurance. If they get caught, they will be in trouble.

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    2. This is also an issue that we will be discussing with "Case Presenting". I will make sure to touch on this question next month!

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    3. Yes this is indeed insurance fraud and most states have laws that prohibit medical and dental practices from forgiving co-pays without putting effort to collect payment. You can't do anything when patients skip town, other than sending their bill to a collection agency, but you can't waive co-pays or deductibles if you are contracted with the patients PPO plan. It's against the law and if you get caught the insurance company can sue you and your local dental board may impose a fine or disciplinary action. I see it happen every day, unfortunately.

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  6. The Lecture keeps cutting out on me. Anybody else?

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    1. I belive that I fixed that issue! please email me if you have this happen again. curtis.marshall@gmail.com

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  7. Has Ben ever heard of the KODAK study??? I was losing money on every patient that had DELTA DENTAL. I was writing off 33% with a 68% overhead. That is a loss!!!! So, no matter how many people we saw, we were still losing!

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    1. As long as those number are true over time, and not a feeling. Then YES drop that insurance. "When we deal in generalities, we shall never succeed. When we deal in specifics, we shall rarely have a failure." Thomas S. Monson

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    2. Yes I have heard of the Kodak Study and I understand it very well. I'm not a big proponent of joining PPO plans unless you negotiate fees. I'm in the business of beating up insurance carriers to get better reimbursements for dentists and helping doctors reduce their write-offs. Negotiating fees is only 1 aspect of operating a sucessful dental practices. I negotiated great fees for a dentist in Chicago Illinois and he kept complaining that he wasn't seeing a difference in his practice since his overhead was so high. I sat down with him and took a look at his P&L. His supply cost was 17%! The national average is 6.2%. I'm not a consultant but I did share the national average numbers with him and in 2 hours he found Pearson Dental Supply and cut his supply costs down to 5.9% and saved $113,000 in supply costs that year. You can have great PPO fees, but there are other areas of the practice that might need some adjustment to reduce overhead and have more take home income.

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