Wednesday, July 20, 2011

Delta Dental Premier

After consulting with patients, friends, employees, and family, I have decided to start accepting the Delta Dental Premier plan. With Delta Dental taking over the management of the dental insurance program for the State of Illinois, this change was almost unavoidable. The State of Illinois is a very late payer, sometimes taking 7 months to a year to pay. With Compdent, their previous dental insurance manager, the insurance payment was sent to our office. If the office is not a Delta Dental Participant, the insurance payment goes to the patient. This creates a situation where we would have to ask for payment up front at the time of service. If we didn't do this, many patients would not only get free dental work, they would also get paid for having dental work done. While it would be nice to get paid at the time of service, the current paradigm for health care is to pay a small co-pay and let the insurance deal with the rest. Many patients are too used to not paying at the time of service for health care and would choose another dentist who was part of the network.

Delta Dental Premier is not the same as Delta Dental PPO, and both plans are different from the plan for the State of Illinois. In order to join Delta Dental Premier, I have to cut my fees to all Delta Dental patients to a fee schedule which is about 10-25% lower than my usual prices. The State of Illinois' plan would require me to cut a little more for some procedures, and the PPO plan would make me cut many of my fees in half.

If I went with the PPO plan, there would be too much incentive to cut quality and time spent with patients in order to stay in business. Also there would be an incentive to only provide services that are higher in margin. The main problem I have with some dentists in the PPO plan is that the incentive for planning unnecessary treatment is too great to overcome, and many patients are getting unnecessary procedures done.

Capati Dental will strive to keep giving the special quality treatment for our patients just as we have done in the past. I will try my best to not let 3rd parties influence my judgment. I will always try to treat all my patients like I would myself, my family, and my friends.

-Albert Capati