THE GOOD, THE BAD, AND THE UGLY by Tammy L. Carullo, RDH, PMC, PS

Many have subscribed to the philosophy that if we all simply go the insurance free route, life in dentistry will be blissful. In fact, I used to lump myself in with the "gurus" of whom are actively pushing the anti-insurance movement in this country, but not anymore. This is not a simple black and white issue, there's a heck of a lot of gray area involved. There are always two sides to every story, and pros and cons with every decision we make. As a consultant, I have seen some practices make this transition very smoothly and successfully, but I have seen the untold truths of practices that have gone belly up as a result of dropping insurance. Some practices, patient bases, and locations can support such a decision, others cannot. How many times do we need to bang our heads into the same brick wall, before we get it? All practices are NOT created equal, and therefore, blanket, mainstream, cookie-cutter ways of doing things are not going to work across the board!

So, what do you do? Well, first you have to evaluate your situation for what it really is. How much of your patient base is involved in insurance, and to what degree? How much of a "headache" is insurance to you, not the guy down the street, not the celebrity guru, but YOU? And if insurance is causing your migraines, investigate WHY. It could be something as minor as organization and adequate processing of claims to rid yourself of your insurance nightmare. A great practice management software like PracticeWorks can make a HUGE difference in your tracking capability and make integrating insurance easy and very practice friendly. So, before you take a leap off the pier and decide to drop insurance, you had better know what you're jumping into. Many docs are being so misled on this issue because they are being fed this major line of BS that's telling them everything that is wrong in your life and in dentistry is the fault of insurance–it's ludicrous! That's like saying everything that goes wrong with a computer is the computer's fault, when in actuality 99% of the time it goes back to human error.

Insurance has always been a component of dentistry and as much as we try to distinguish dental from mainstream healthcare, patients in large, don't. In a perfect world, the dental benefit patients receive would play second fiddle to the treatment they need. In my experience, a successful practice is dependent on patient finances. Without insurance benefits, I’m afraid more practices will suffer the "closing your doors" fate. We need to accept the insurance industry is multi-million dollar, with a lot of very strong political and financial ties. They're not going away! But your decision to participate, accept assignment, or be insurance free is one only you can make. Having the right systems, the right software like PracticeWorks, and the right procedure of submitting and tracking claims can make all the difference. Allowing outside pressures to influence you in either direction is not the answer, investigating to see which your situation can support and what you can do to positively change your situation by taking appropriate action, IS the answer.

DECISION TIME!	PROS	CONS
Insurance	1) Financially Beneficial to     Patients	1) It takes time to process claims,     telephone issues, etc.
	2) Increased Case     Acceptance	2) Patients can become too focused     on $$ rather than necessary care
	3) Increased Practice     revenue	3) Insurance denials, rules,     regulations that can be frustrating
	4) Easy marketing
	5) Provides better access      to care
	6) Conveys priority of care to     patients (more will come if     they have insurance)
Insurance Free	1) No more claim forms	1) Decrease in Case Acceptance     due to out-of-pocket increase
	2) Getting paid at the time     of service	2) Decrease in patient base
	3) No more insurance based     decisions regarding     treatment	3) Increased marketing expense     to offset patient attrition

I have the utmost respect for those in the industry who believe that insurance free is the way to go, but there are different and equally successful ways of doing things. The above chart shows some pros and cons for either decision, you do the math, and figure out which scenario will best help your practice. Insurance may be great for some, unbearable for others. And insurance free may be the answer for some, and spell disaster for others. Make your decisions based on facts (what your practice and demographics can support) not pressure from either side.

Tammy L. Carullo, RDH, PMC, PS is a professional speaker, Senior Consultant, and an 18-year veteran in dentistry. She is the CEO of Practice by Design Consulting, Inc., one of the fastest growing, privately held practice management companies in the country. For more information call (717) 867-5325 or go online to www.practicebydesign.com today. Mention you're a "Townie" and receive special discounts on seminars and consulting services!