Dentaltown June 2014 - (Page 22)
ethical dilemma
feature
Welcome to the new world of dental insurance. The days of
being able to contract only with the insurance company directly
are gone. With the exception of Delta, every major insurance
company now has some sort of shared network agreement for at
least a portion of their networks. Some offices may find third
parties a good fit, others are being blindsided by them. One area
of the country may find superior fee schedules with a third party
while direct contracts may come in higher in others and different business models within dentistry vary in how useful or
harmful a third party administrator could be.
As the insurance landscape continues to change rapidly, you
and your staff must have clarity and predictability with your contracts so that you have control over what you accept. When
patients call to ask if you are in-network, your staff must have a
clear "yes or no" answer to give and that is becoming an increasingly challenging, if not impossible, task.
What are Third Party Administrators and How
Do They Work?
There are multiple national and regional third-party administrators, repricers, hybrids. Some of the more recognizable national
names are DenteMax, Connection Dental and Maverest, with
smaller networks like Premier Group and First Dental Health
being found in certain parts of the country, but not necessarily all
states. A third party administrator is not an insurance company.
Insurance companies contract with third party admins so that their
company is also considered in-network under that third party's
contracts. Dentists also contract with the third party to be
by Sandi Hudson
22
JUNE 2014 » dentaltown.com
http://www.dentaltown.com
Table of Contents for the Digital Edition of Dentaltown June 2014
Dentaltown.com Highlights
Howard Speaks
Professional Courtesy
Continuing Education Update
Insurance Changes--Buyer Beware (and Be informed)
The Art of Hand Filing
The Value of Magnification, Documentation and Ergonomics
Currently In-network with a Lot of Plans
High Tech, Low Overhead
Second Opinion: What Exactly is Modern Endodontics?
Patency and Profound Anesthesia
Eliminating the Ding of Endodontics
You Should Know: EdgeEndo
Improved Dentistry through Advanced Digital Radiography
Black and White: Diagnosing Doesn’t Have to be Gray Area
Ways to Make the Internet Your Best Source for New Patients
Digital Microscopy
You Should Know: Dentyzion
Poll: Implants
Function Meets Aesthetics: Advanced Materials for Posterior Restorations
Disability Insurance, Another Look…
Inside United Concordia
Ad Index
Perio Reports
Excuse Me, I’m Talking Here
Dentally Incorrect
Dentaltown June 2014
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