Choosing the right insurance networks for your dental practice is one of the most important business decisions you can make, but it’s not a one-time choice. In the wake of rising overhead costs and changing reimbursement rates, it’s important to regularly evaluate if you’re in the right dental insurance networks. Many dentists credential with multiple insurance providers early in their careers to attract new patients, but years later they might not be a great fit. If this sounds familiar, it might be time to evaluate if you’re in the right dental insurance networks.
What Are Your Current Reimbursement Rates?
The first step in determining whether you’re in the right networks is to take a close look at your reimbursement rates. For each insurance provider you’re in-network with, compare the fees you’re being paid against your usual and customary rates. Are you being reimbursed fairly for your time and expertise? If your reimbursement rates are significantly below your overhead or not covering the cost of delivering care, it’s a clear sign you need to evaluate if you’re in the right dental insurance networks or consider getting help negotiating your reimbursement rates.
What Patients Are Going to Be Impacted?
It’s easy to assume that staying in lower-paying networks is worth it if they are bringing you a high volume of patients. However, volume doesn’t always equal profitability. Look at how many patients each insurance plan brings in, how often they return, and what their treatment plans look like. As you evaluate if you’re in the right dental insurance networks, you need to consider what the impacted patients bring you. For example, if one plan brings a high number of patients, but those patients don’t accept comprehensive treatment or only come in for cleanings, the network may not be contributing much to your bottom line.
What Are the Administrative Costs?
Being in-network can mean dealing with denials, coordination of benefits, and more. All of these tasks take time and put more work on your plate. If certain plans create excessive administrative burdens, this is another reason to evaluate if you’re in the right dental insurance networks. Think about how much time your front office spends working with each insurance provider and if some plans are creating more stress than value. Reducing administrative complexity can improve efficiency and reduce staff burnout, even if it means seeing fewer patients.
How Does the Plan Align With Your Overall Goals?
Your insurance participation should support your overall long-term vision for your practice. Are you trying to grow as quickly as possible, or are you focused on maximizing profitability with fewer patients? Do you want to build a boutique, relationship-driven practice, or a high-volume clinic? As you evaluate if you’re in the right dental insurance networks, you should try to align your participation with your strategic goals. A plan that once helped you fill your schedule may now be holding you back if your goals have changed.
Grow Your Practice with APEX Reimbursement Specialists
It’s no longer enough to “set it and forget it” when it comes to insurance participation. To stay profitable and in control of your practice’s future, you need to regularly evaluate if you’re in the right dental insurance networks. APEX Reimbursement Specialists is here to help. Contact our team today by calling (410) 710-6005. We look forward to working with you to make your practice a more profitable place.