Editor's note: I asked dental insurance expert Teresa Duncan for her thoughts on the recent DrBicuspid.com reader survey that showed insurance reimbursement was one of the top stressors for dentists and dental team members today.
It’s not surprising to see reimbursement listed as a stress point for practices. It’s the equivalent of being stuck between a rock and a hard place. It’s hard to plan raises and technology investments when your fees are locked.
Teresa Duncan.
How can you increase revenue when you can’t raise fees? Conventional business wisdom will tell you, "by becoming incredibly efficient." This doesn’t work largely for two reasons: increased administrative burden and wages.
For many practice leaders, the term "administrative burden" is an emerging concept, because insurance management has never been so nuanced and difficult.
Insurance coordinators navigate increasingly complex network arrangements, submit (and resubmit) treatment documentation, and spend countless hours on hold to discuss coverage. This administrative maze forces dental teams to hire or outsource to insurance specialists.
The mathematics become particularly troubling when you consider that labor and time spent on administrative tasks carries the same cost whether reimbursements are high or low.
When reimbursements drop but administrative demands increase, practices face a double financial penalty that squeezes profit margins and creates workplace stress that ultimately affects the patient experience and team retention.
It’s not an easily solved problem. The online chorus of "just go out of network" doesn’t consider an office’s demographics, team capabilities, or the local employer mix. When you consider these factors, it’s understandable that practice owners feel increased stress.
What’s the bottom line? No easy solutions exist to fix our industry’s reimbursement issue.
Teresa Duncan’s classes focus on insurance and management issues. She is the founder of the Dental Revenue Network. She has contributed annually to the ADA’s CDT Coding Companion Guide. Her podcasts Nobody Told Me That! and Chew on This are resources for dental leaders. Duncan received her master’s degree in healthcare management.
