The business side of the dental profession can be excessively complicated, and if there is that one aspect that bothers dentists most, it has to be PPO insurance. Although operating expenses are on the rise, dental insurance reimbursements are not improving.
Your practice is a business that needs to earn to serve more patients. This is why it’s important to keep track of the returns based on dental insurance reimbursements. Doing this will prepare you to work with insurance companies and convince them to increase dental PPO reimbursement rates.
Here is a guide on how you can analyze reimbursements and negotiate successfully with insurance agents:
The first step is to study what your operation is about. You may know some of your practice’s top billing procedures, but a more comprehensive analysis will let you know exactly which services you must discuss with insurance agents. Evaluate your existing contracts with dental providers before getting in touch with the payer. This will give you a concrete idea of the rates you are getting.
Be sure to identify your leverage as well. You can do this by running a quick local search for maybe something like “insurance company name dentists”. Just that one query will give you an idea or an exact figure of how many doctors in your area subscribe to the same PPO plan.
Your negotiating letter must be two things: short and straight to the point. Insurance company representatives have a lot on their plate, so keep your letter clear and concise. One paragraph is enough; save all the details for the phone conversation.
During the actual negotiation process, the most important tip you need to remember is make sure you’re talking to the right person. Avoid call centers and 800 Provider Relations. These representatives don’t have control over changing terms in a PPO plan.
The best place to have your negotiations is the provider retention department. People in this department are given incentives when they are able to achieve specific recruitment numbers and keep a certain number of active participating providers. They are the best people to do negotiations with.
Keeping track of your dental reimbursements will help your business become more profitable. Although reaching out to insurance companies may be a little nerve-wracking, the right preparation helps ensure a successful negotiation.