Read the fine print

At this time, Delta Dental is no longer allowing practices to participate in Premier-only plans. As this is a phased approach, in California, a new Delta contract requires all new participants with Delta agree to see not just the Premier patients, but also all patients on any Delta PPO plan. Because a great majority of California doctors are on the Delta Dental Premier program, no California doctor on Delta Premier can hire an associate unless they will only see non-Delta Dental Premier patients. The same will apply to all states as it is rolled out.

Know your fees

Because Delta Dental Premier is the higher-paying program, dentists are being forced to join their lower-paying PPO plan if they wish to stay in the network. By choosing to stay on with Delta, your practice must accept all PPO patients, which often come with $1,000 or more fee discounts. These lower reimbursement rates threaten to reduce practice profits and significantly lower the value of affected practices. However, before rushing to sign up for the lower paying PPO plan or drop Delta participation altogether, remember in the average practice, insurance company reimbursements account for less than half of the total receipts.

Exercise the competition

Many fee-for-services dentists only participate in Delta Dental, leaving their options limited in terms of services and fees. But just as you wouldn’t enter a contract with the first and only dental supplier, dental practices should explore all options for coverage contracts. As with all business decisions, knowing your options will only help leverage deals and speak more intelligently to keep your contractual obligations honest. When given power of exclusion, any organization will do what’s in its best interest and not in the interest of clients, so it’s important and necessary to keep your options open.

What’s next?

Contact the experts at Professional Transition Strategies for all the insider information on dental insurance. 

The original article can be found on the Professional Transitiom Strategies website