Some patients cannot afford certain dental treatments and services. Others do not visit the dentist at all. Even with dental insurance, patients still have to pay out-of-pocket for some treatments. Dental offices could offer discounts for these patients, but they should still raise their fees to support their operations.
Discounts could not only appeal to new patients, but also assist them with their costs. Though, clinics must still make enough money for their overhead costs when they offer reduced prices to patients (Savage 2012). Likewise, clinics in PPO insurance networks have to consider their overhead costs, since they provide treatments and services at reduced costs due to insurance coverage (Philhower 2013). Even so, discounts could help alleviate patients’ costs, especially for necessary treatments. For patients with insurance plans, clinics could reduce their copayments by reporting the reduced prices for their treatments in their claims (“Dental benefits 101: Proper billing, waiving co-payments” 2016). They commit fraud if they waive their copayments, coinsurance, or deductible in an effort to bring in new patients because this decision “[overbills] the insurance company” (“Beware of offers to waive coinsurance/copayment amounts”; “Dental benefits 101: Proper billing, waiving co-payments” 2016). Though, clinics could “reduce or waive such charges [i.e. patient cost-sharing amounts for out-of-network services] in accordance with an established financial need policy” (Barry and Herschman 2017).
While discounts help patients, dental clinics should consider raising their fees in order to keep up with overhead costs and earn more income. Sally McKenzie, “CEO of McKenzie Management,” recommends raising fees when they are low compared to other dental clinics’ in the area, when fees are “too low for certain services and too high for others,” and when the clinic is not doing well economically (2017). For clinics that follow PPO fee schedules, they could negotiate with insurance companies to increase the fees of some of their procedures, especially if other clinics in their area have more profitable fee schedules (Blair and Blair 2013; Burniston 2015). Negotiating with insurance companies could be difficult, but clinics could achieve negotiating terms advantageous to them (Blair and Blair 2013; Burniston 2015). Kevin Wilson, “CEO of Sterling Management,” says that raising fees causes clinics to lose “between 2% and 30% [of patients], depending on the patient base” (2016). For example, “[if] the patient base is low-income and cash-based, then the loss will be on the high side” (Wilson 2016). However, raising fees may attract patients that “don’t mind paying for high quality dental care” instead of patients more concerned with their costs (Wilson 2016). Also, with a higher revenue obtained from increased prices, clinics could “invest in training, technology, and practice upgrades” (McKenzie 2017).
Discounts help clinics attract new patients as well as assist patients paying for their treatments. Raising fees helps dental offices increase their revenue in order to maintain and improve their operations. Clinics must find balance between these two financial moves.
Works Cited
Barry, John D. and Gary W. Herschman. “The out-of-network co-pay conundrum – To waive or
not to waive … And how?” Becker’s ASC Review, March 24, 2017. https://www.beckersasc.com/asc-coding-billing-and-collections/the-out-of-network-co-pay-conundrum-to-waive-or-not-to-waive-and-how.html.
“Beware of offers to waive coinsurance/copayment amounts.” Delta Dental. Accessed October
12, 2017. https://www.deltadentalins.com/individuals/guidance/no-copayment.html.
Blair, Charles and Trip Blair. “Strategic fee positioning and checkpoints for your practice.”
Dental Economics, February 1, 2013. http://www.dentaleconomics.com/articles/print/volume-103/issue-2/features/strategic-fee-positioning-and-checkpoints-for-your-practice.html.
Burniston, Kevin. “Negotiating insurance fees.” Dental Economics, May 15, 2015.
http://www.dentaleconomics.com/articles/print/volume-105/issue-5/practice/negotiating-insurance-fees.html.
“Dental benefits 101: Proper billing, waiving co-payments.” CDA California Dental Association,
December 21, 2016. https://www.cda.org/news-events/dental-benefits-101-proper-billing-waiving-co-payments.
McKenzie, Sally. “Is it time to raise the fees in your dental practice? How to tell.” DentistryiQ,
April 6, 2017. http://www.dentistryiq.com/articles/2017/04/is-it-time-to-raise-the-fees-in-your-dental-practice-how-to-tell.html.
Philhower, Jim. “How PPOs are affecting the value of your practice.” Dental Economics,
December 18, 2013. http://www.dentaleconomics.com/articles/print/volume-103/issue-12/practice/how-ppos-are-affecting-the-value-of-your-practice.html.
Savage, Rhonda R. “Getting pricey! The high costs of discounts and courtesies.” DentistryiQ,
February 13, 2012. http://www.dentistryiq.com/articles/2012/02/getting-pricey-the.html.
Wilson, Kevin. “Dental practices continue to undercharge for services: What you can do to
change that.” DentistryiQ, February 5, 2016. http://www.dentistryiq.com/articles/2016/02/dental-practices-continue-to-undercharge-for-services-what-you-can-do-to-change-that.html.
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