Broker blog from Delta Dental

Tag: dentists

Dentists seen as an economic indicator

The dental industry may be a good indicator of whether Americans have fully recovered from the pandemic, according to a June New York Times article. This is because dentists offer a unique service that has no clear alternative.

Since the coronavirus (COVID-19) pandemic hit the U.S. in early March, the national economy has seen a downturn and a subsequent uptick. The dental industry experienced an amplified version of these national employment trends, with half of all dental workers losing their jobs in March and April, and 94% of dentist offices rehiring their full staff by mid-August.

Getting dentists back into the office

Stimulus programs may be a key factor in helping dentists to weather this storm. Practices that took part in the federal Paycheck Protection Program were more likely to remain open than those that didn’t.

Even after job gains since June, the dental industry still has 289,000 fewer workers than it did before the pandemic. That suggests to Betsey Stevenson, a University of Michigan economics professor quoted in the Times article, that the industry — and the rest of the American economy — is far from recovered.

What does the future look like?

Though dentist offices have been open for several months, it’s unclear whether their patient bases will return. In mid-June, most states gave dentist offices the go-ahead to reopen fully, but in August patient volumes were still lower than what they were before the pandemic. The rate at which patients were returning has even tapered off as of mid-August and some economists don’t predict patient volumes to return fully before the end of 2020.

This hesitation is a sign of multiple problems facing patients during the pandemic. Some patients may feel cautious about removing their masks for a close-up procedure. Others may think that since they haven’t noticed any dental issues since the pandemic started, they can go a little longer without getting a dental cleaning. Some people can simply no longer afford dental procedures after losing their jobs and their insurance benefits through their employers. Economists who spoke to the Times predict that employment rates for dentists will eventually return to where they were before the virus hit, even though it may be slow going.

What to ask about leased dentist networks

Cars, houses, clothing, even dogs — the list of items Americans lease today continues to grow. The world of dental benefits is no exception to the trend. Oftentimes, to expand network size, a dental carrier will lease a dentist network from a third party (either another carrier or a company that aggregates dental networks). While the potential for more dentist access is tempting, it’s important to know if a leased network can truly deliver more value.

If you’re recommending a carrier who leases its dentist networks, ask these questions to see how it could impact your client.

1. Who holds the contract with the leased network dentist? The primary carrier or a third party?

Why it matters: In many cases, when a carrier leases a dentist network, there is no direct contract or relationship with the leased dentists. This may create difficulties in resolving disputes through a third party, which could mean unhappy enrollees. It may also cause confusion about which claims guidelines and processing policies apply. This could leave enrollees waiting longer for a claim to process or even cause an enrollee to be billed incorrectly.

2. Are leased network dentists held to the same credentialing and quality standards as non-leased dentists? Are they continually monitored by the primary carrier?

Why it matters: When portions of a dentist network are leased, there’s a possibility that their equipment, office cleanliness, treatment plans, safety measures and/or patient history have not been vetted as thoroughly as a carrier’s direct-contracted dentists. Furthermore, if the primary carrier is not involved in monitoring the leased network dentists, there may be no guarantee that these dentists are re-credentialed every three years or that they are credentialed to National Committee for Quality Assurance (NCQA) criteria.

3. How much of a carrier’s dentist network is leased?

Why it matters: Dentist turnover might be higher if a carrier leases dentists. Why? Because a leased dentist’s network agreement could end before a group’s benefits contract. This means, if a large part of a carrier’s dentist network is leased, there could be a greater chance enrollees will find their dentist is suddenly no longer in network.

4. Which fee schedule takes precedence when an enrollee visits a leased network dentist?

Why it matters: When a carrier leases a dental network from multiple companies or carriers, the same dentist could end up in more than one leased portion of the network. If this is the case, a group may end up with multiple fee schedules, which is known as stacking. This could cause inconsistent costs for the group if different fee schedules are applied across the network. Dentists may also be confused about how to bill enrollees, which could potentially increase claims costs depending on which fee schedule they apply.

5. How does the carrier ensure the accuracy of its leased dentist directory?

Why it matters: If a carrier does not hold a direct contract with its leased network dentists, it may be hard to ensure the accuracy of the dentist directory. This could create an unpleasant surprise for an enrollee if they’re billed for an out-of-network visit when they thought the dentist was in network. It could also lead to overstatement of network size.

6. How much is the network access fee when an enrollee visits a leased network dentist?

Why it matters: A bigger network does not always mean bigger savings for the group. If a carrier leases dentist networks to increase their network numbers, groups need to consider how much they’re being charged for access to the additional dentists. These fees may differ between portions of the network.


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Warmest wishes from Delta Dental

We want to take time out of this busy holiday season to let you know that we appreciate the trust you place in us, and our ongoing partnership. We enjoy working with you and your clients, and look forward to continuing to help you grow your business in 2017. Here’s to the happiest of holidays and a prosperous New Year!

5 dentists your clients won’t find in our networks

At Delta Dental, we don’t lease any of our dental networks. In fact, our Professional Relations department specializes in developing close relationships with our providers to ensure quality care for enrollees. This Halloween season, we’re showing you what not to expect in our networks — and that dental visits might not be so scary after all.

Mother and daughter carving pumpkin

Here are some doctors enrollees won’t find in our networks:

  1. Philip Sherman, Finding Nemo

Okay, so P. Sherman might not be your run-of-the-mill villain, but why would anyone want to visit a man who lets his niece torture adorable sea creatures? Plus, enrollees can find a credentialed network provider easier than getting “just keep swimming” stuck in their heads with our Find a Dentist tool.

  1. Stuart Price, The Hangover

While Stu seems like a stand-up guy, enrollees probably don’t want to look up from the chair and see a dentist with a missing tooth, a knot on his head and point-blank taser wounds on his neck. Ouch.

  1. Wilbur Wonka, Charlie and the Chocolate Factory

Unlike Willy Wonka’s father Wilbur, we don’t believe that “lollipops ought to be called cavities on a stick.” While our dentists want patients in great oral health, they don’t use scare tactics to achieve wellness. Instead, our dentists encourage regular preventive care and good oral hygiene to combat plaque and decay. (For wellness tips that your clients can share with enrollees, check out our SmileWay Wellness Program.)

  1. Orin Scrivello, Little Shop of Horrors

Arguably the most evil dentist character ever played, Orin is the exact opposite of what you’ll find in our networks. In fact, we have a whole team of dental consultants on staff dedicated to reviewing claims and preventing fraud, waste and abuse.

  1. Mindbender, G.I. Joe

There’s no mind bending or brain scrambling here — thanks to our enrollee Online Services! Enrollees can log in at deltadentalins.com to view their benefits, check claims status and even look up average submitted fees for common services with our Fee Finder tool.

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