Negotiating insurance fees

Did you know that insurance companies do not pay all dentists the same amount for the same services? Some dentists could receive 10% more from the same insurance company depending on how they negotiated, when they negotiated, and if they partnered with a negotiation expert.

Kevin Burniston

Did you know that insurance companies do not pay all dentists the same amount for the same services? Some dentists could receive 10% more from the same insurance company depending on how they negotiated, when they negotiated, and if they partnered with a negotiation expert. Every extra dollar negotiated is one more dollar in the dentist's pocket. In a million dollar practice, an additional 10% in fees could be an extra $100,000 in income. Why don't all dentists just negotiate higher fees from insurance companies?

Negotiating fees has changed dramatically over the last five years. The days of calling up the insurance company every year and asking for a 5% increase (and receiving it) are long gone. Insurance companies are less likely to negotiate today because insurance has changed overall. Preferred provider organization (PPO), the number one plan sold today, has increased from 35% to over 85% of the market. More and more dentists are choosing to go in- network-and the more who do, the less the insurance companies are willing to negotiate. Employers are looking for ways to save money on medical and dental costs, and lower fees directly impact an employer's bottom line.

The first step in negotiating better fees is to know where you stand. How do your fees compare to others in your area? Not all fee surveys are created equal-many are compiled by a local accountant or consultant using a small sample size. We at Henry Schein have compiled a survey with over 700 million submitted fees to give us the most accurate fee schedule possible. We've made it much easier for an office to compare its fees to those within its five-digit zip code. Having accurate information is important when choosing what to negotiate with insurance companies.

The next step is to examine how many insurance companies you are contracted with. Although you may think you know the answer, you probably don't know the true number. If you have signed contracts with five or more insurance companies, there is a good chance you should double or triple that number. Insurance companies contract with one another to allow them to share patients and fees. When you signed a document with one insurance company, you may have signed an agreement with a group of insurance companies. This is why it is important to sign only with insurance providers you feel are necessary and to read the fine print.

If negotiation seems like a lot of work, that's because it is. Negotiating with insurance companies has become difficult, even impossible. If you'd like better fees but do not want the hassle, there are companies designed specifically to help you (e.g., Unitas Dental, Five Lakes). The major advantage these types of companies have is the power of numbers-they represent hundreds of dental offices and know what insurance companies are willing to do. A negotiating partner can help as contracts change throughout the year. Another great advantage of these companies is the ability to reach out to them with reimbursement questions when an insurance company refuses to pay.

The Henry Schein team believes in improving the lives of those we touch. We focus on care of the practice so dental professionals can focus on care of the patient. Fee negotiating is just one way we'd like to help your practice thrive. Please reach out to your local Henry Schein representative for more information or visit www. HenryScheinBusinessSolutions.com/Insurance.


During his 10 years with Henry Schein, Kevin Burniston has had the opportunity to meet with more than 1,000 dentists. Each one has unique hopes, dreams, and concerns about his or her practice and family. Kevin's goal is to help each dentist reach those dreams. Contact him at (800) 372-4346 or kevin.burniston@henryschein.com. Learn more at www.HenryScheinBusiness Solutions.com .

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