Why Do We Deal with Insurance?

The most cited complaint within a dental office stem from stresses generated when dealing with dental insurance.  Stressors can range from simple irritation about response times and misinformation, to declining reimbursement trends, increasing incidence of claim denials, disallows or audits.  Why then do we deal with dental insurance at all?

Consider these statistics from the ADA, NADP, and CDC:

·       Only 40% of the U.S. population visit the dentist each year.

·       Over 50% of people in the U.S. have private dental insurance and another 25% have public insurance.

·       78% of patients with private dental insurance visit the dentist annually.

Clearly, we can see that the patients who have dental insurance go to the dentist far more frequently than those who do not. The availability of insurance does serve as a catalyst that drives many patients to see us in the first place.

Patient Mindset

According to an ADA study from 2015, the number one reason cited by far from patients (59%) on why they do not go to the dentist is cost. Let’s explore this issue of “cost.”

Americans tend to prioritize the things they want far more than things they need. When was the last time you heard someone with a top-of-the-line smartphone, new car, or recent vacation complain about how they have no money for other expenses (such as healthcare)?

In most cases those luxury items are far more expensive than a trip to the dentist.  Why then are those seen as “affordable” when dentistry is not? It is because they planned savings or financing for the items they wanted and did not plan for the items they needed. When they say cost, they actually mean affordability: having “available” money to spend on dental treatment.

Insurance as a Savings Plan

Many people need an automatic savings vehicle for expenses that they need, because they are not disciplined enough to save without one.  Dental insurance, no matter how good or bad it is, helps solve this problem for the patient.  It automatically removes money from their paycheck or account and puts that money into “savings” for dentistry.  You hear it all the time in the industry, dental insurance is not “insurance”, it is a savings coupon. This is completely true. And those patients with higher end needs can save for dentistry, they just must want to (just like they did for that car or vacation). 

Dental insurance provides a structured plan to pre-pay and save for future dental needs, and it clearly works as seen by the usage statistics across the country. People with insurance go to the dentist because they are already paying for it.

Whether in or out of network, we deal with dental insurance because a majority of those who visit the dentist have it. When the patient has a benefit, they want to utilize it, and we need to be there to help.