One of the biggest barriers and frustrations among patients is that dental insurance just isn't what it used to be. Over the last 40 years, the amount of money dental insurances will pay toward treatment remains the same (about $1000), but like everything else in the world, the prices for treatments have gone up. The result is that patients perceive their dental insurance will cover all or most of the treatment they need, when in reality it doesn't come close. Dental insurance has also been denying claims at record rates and requires much more documentation (photos, x-rays and lengthy rebuttals) in order to pay on claims.
Historically when a new dentist hung their sign, they needed a way to attract new patients. The most common way was to do in-network marketing and join insurances plans. It was a mutual arrangement where the dentist would takes less money for their services in exchange for the insurance company sending patients their way. For example, if a dentist charged $100 for the cleaning, they may agree to only charge the insurance company $60 and write-off the other $40. Once a dentist builds up their patient base, they no longer need to "market" themselves as they become busier. The result is that they sever their in-network insurances so that they can operate more productively. As a result, the insurance company would pay their $60 and the patient would pay $40 to make up for the deficit.
Coming in to an established practice, we have a large patient base and Dr. Davis had already cut ties with the majority of insurances carriers. He remained with Dental Care Plus (under the umbrella of Dentaquest) due to Mason City Schools choosing that plan for their employees. We wanted to keep the teacher's plan and ensure they could be a part of the practice on an in-network basis. However, Mason City Schools has decided to end their relationship with Dental Care Plus and switch to an out-of network provider that we are unable to accept due to low reimbursement rates. For illustrative purposes, their new company would force us to write-off 60% of our fees for services. Considering our operating expenses are higher than that percentage, we would LOSE money to see patients under Delta Dental with the high standards we operate our office.
While dental insurance hasn't changed, one thing that has, is the ability of our office to offer a membership plan. This has made sense for the majority of our patients who are not in network, are retired or are self-employed. We have a brochure going over fees and structure. If you are interested, please contact the office.
I hope this sheds some light on our decision and we hope you consider the value of having a dentist and team that truly care. We don't skimp on time required to provide a comprehensive and thorough dental hygiene experience, whether it takes 60 minutes or 90 minutes. We will always stay abreast to the newest advances and technology. I continue to invest in the comfort and appearance of the office. We are able to retain our wonderful staff due to offering them living wages and benefits. While we understand if it's no longer possible for you to remain a patient out of network, we hope you keep us in mind should your position ever change. (But seriously, check out our membership plan, it just may be cheaper than your "insurance" that very few dentists accept :).
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