Dependence on insurance

June 1, 2002
Continued profitability is important. It is one of the main reasons you chose dentistry. In changing economic conditions, is it feasible for a dentist to become a nonprovider of insurance?

By Bill Blatchford, DDS

Continued profitability is important. It is one of the main reasons you chose dentistry. In changing economic conditions, is it feasible for a dentist to become a nonprovider of insurance? If you continued to be a provider during the last 10 years of boom economy, are you forever tied to insurance? If I make changes, how will it affect my profitability?

Insurance decisions are emotional. And yet, it is fiscally irresponsible to make a decision strictly on an emotional level that will greatly affect your profitability. It takes an emotional and financial assessment and a solid plan of action.

On an emotional level, you need introspection to discover why you want to be a nonprovider. Know your reasons. What is the purpose of coming to work each day? What are you and your staff trying to accomplish? Words such as excellence, results, choices, freedom, and responsibility may come to mind. How then does insurance support fit for you? In your opinion, how can you best provide excellence and freedom of choice?

You decide, for that decision is based upon your own ethical standards.

The financial assessment is simply numbers. Find out your percentage of collections from insurance.

The number of patients on insurance does not matter. You need to know the amount of treatment being accepted in your office and supported by insurance. If you have more than 50 percent of your collections coming from insurance, you still have several choices. You need to plan for the worst. If 50 percent of your practice left, would you still be operating?

One choice is to continue as you are and keep challenging fees and diagnosis. Another choice is to establish an "insurance independence" date several years from now, such July 4, 2004.

The goal is to change the mix of treatment being offered in your practice from the current "crown of the year" club, "just fix the worst one," or "just do what my insurance will cover." Moving from crown of the year club to offering more optional treatment requires new sales skills. This is no pressure sales where you ask the patient questions. If you have a 50 percent insurance collection, you and your staff, as well as your patients, are mentally tied to insurance. It is on your mind all the time, and you are aware of each patient's insurance, thinking there is no other path.

As you change the mix of treatment offered, your goal is to show a decrease in insurance dependence. You need to become more skilled in relationships - selling, rather than telling, and attracting patients to your practice who see value in work beyond their insurance maximums. Learn how to create value for treatment not covered by insurance. Ask your patients what benefits or advantages they see in healthy teeth and smiles.

If you choose to become a nonprovider of insurance, your plan for profitability must include the increasing of your marketing, sales skills, and budget. Since insurance companies have been your marketers, you must fill the void. Insurance has provided your sales. If you use the same sales technology when selling optional care, it will not be successful. An insurance sale is, "Let's preauthorize this," or "Let's fix the worst two." The expected response is, "I'll do what my insurance covers."

Evaluate your ability to become a nonprovider by examining your own numbers. Plan for that percentage of your practice to leave. If that percentage of treatment left your practice, where would you be? Change the mix of treatment to more optional care and make a plan for learning marketing and sales skills.

Dr. Bill Blatchford is one of the strongest voices for fee-for-service dental practices in America. He is president of Blatchford Solutions. His coaching program focuses on results in profitability, leadership, and case acceptance. Dr. Blatchford has an acclaimed monthly audio newsletter, The Blatchford FILES, which role-plays scripting, communication, vision, leadership, and attitude. He speaks worldwide at most of the major dental meetings. Dr. Blatchford can be reached at (800) 578-9155, [email protected], or visit

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