Due to the nature of the American healthcare system, insurance has become a politically and emotionally charged issue. Lately, our office has received many questions about our relationship with dental insurance, and in particular why we don’t participate in insurances. There are a number of reasons, but they all boil down to the quality of care and doing what is best for our patients. In this blog, we’re going to dig a little deeper into explaining that, and hopefully give you all some understanding of why we don’t participate in insurances.
To start, we’d like to clarify something: while we accept and file all insurances, we do not allow insurance to dictate the kind of care or the type of procedures our patients receive. This is important to us, due to our experience in dealing with insurance companies and seeing the ways in which insurance affects or even determines patient care. If we were to adopt an insurance-driven model, we would in effect be allowing the insurance company to make medical decisions. We’re simply not comfortable with this.
Here’s an example that will hopefully make things a bit more tangible. Let’s imagine a hypothetical patient with a lost or missing tooth, who would like it replaced with a prosthesis or implant of some kind. In most cases, the ideal solution would be a dental implant. The advantages are numerous: implants are attached to the jaw bone directly and thus feel and function just like natural teeth. They require no alterations to the teeth on either side and are effectively permanent. However, if we allowed insurance to dictate what procedure the patient could afford, we’d likely be told that a dental bridge was the only allowed solution. While bridges are sometimes the right answer, in most cases a dental implant would give the patient a much better outcome. Bridges are not meant to be permanent, require alterations to the adjacent teeth, and need much more care and consideration than a dental implant. In many cases, it’s simply not the best decision for our patient, and we refuse to let the insurance company put us in a corner when it comes to quality of care.
Another issue comes with the nature of insurance fees and insurance payouts. Without delving too deep into the financial mumbo jumbo, low payouts, and delays in payment by the insurance company would mean that we would have to see twice as many patients to stay afloat were we a participating provider with any major insurance network. This would naturally create a much more rushed environment and lead to a drop in the quality of patient care. Again, we’re simply not willing to do it.
In the end, it comes down to our relationship with our patients. By not participating in insurances, we can build a greater level of trust and give our patients the best medical advice we can, not the procedures that the insurance company authorizes. Better relationships with our patients and a better choice of procedures for them lead to improved patient outcomes and quality of life. That’s what we got into dentistry to do: help people live their best lives through oral health. We hope this blog helps you understand why we don’t participate in insurances, what our relationship with insurance companies is, and our dedication to giving you the best quality dental care available.