CDA: No one-size-fits-all when it comes to dental benefit contracting

2018 01 18 00 55 4855 Insurance Policy 400

CDA Practice Support receives many calls from dentists who are considering adding or dropping participation with a dental benefit plan/network. The same question comes up repeatedly in these conversations.

"Have you heard of a dentist who joined or dropped their participation with a dental benefit plan and experienced a successful transition?"

My answer is yes.

Typically, the caller then asks a second question.

"Have you heard of a dentist who joined or dropped their participation with a dental benefit plan, which resulted in an unsuccessful transition?"

Again, my answer is yes.

Business decision

“A dentist should not make their decision to join or drop a plan/network solely based on fees.”

It's important to remember that adding or dropping a contract with a dental benefit plan is a personal business decision. There is no one-size-fits-all in these types of business decisions, as what might work for one dentist might not work for another.

You may be asking yourself how a dentist can make a good decision about adding or dropping a dental plan/network participation, but there is one key element in each success story and it's this: The dentist analyzed the pros and cons of adding or dropping participation with the plan/network.

The saying "If you fail to plan, you are planning to fail" certainly rings true in this situation.

Antitrust reminder

I occasionally receive calls from dentists who were in contract with a dental benefit plan, then added or dropped participation with the plan/network and are now experiencing issues related to their decision. What we find is that dentists often make the decision to join a plan/network predominantly based on the fee schedule. A dentist should not make their decision to join or drop a plan/network solely based on fees.

While contracting or dropping participation with a plan is voluntary, CDA cautions dentists that due to antitrust laws, dentists cannot band together collectively and refuse to participate with a plan. For more information on antitrust laws, refer to the ADA's primer on antitrust laws in dentistry.

Cindy Hartwell is a dental benefits analyst with CDA Practice Support, which is a CDA member benefit.

DrBicuspid.com wishes to thank the California Dental Association (CDA) for allowing us to reprint this article, which originally appeared on the CDA website.

The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

Page 1 of 515
Next Page