As a care provider first and a business person second, it can be difficult for dentists to set usual and customary fees (UCR fees) that are both reasonable for patients and sufficient to keep the lights on. Focus groups have found a trend that can lay some of your fears to rest. Yes, the majority of your patients think that your fees are “a little high.” However, that same majority also loves your office and will keep returning. Think of it like how Tesla will keep selling high-end cars, despite the price being “a little high.” Adjusting your UCR fees to market rates and not patient preferences is important because patients will always see them as “a little high.”
Formulating UCR Fees
UCR fees are tracked based on data provided by practices based on actual claims production in any given zip code. Fees are then analyzed to determine and set the fees within percentiles. In other words, there is no single set UCR fee amount. Instead, there is a range of fees depending on percentiles and areas of the country.
Making UCR Fees Work for Your Office
Since UCR fees are set by percentile, it’s important to remember that having fees higher than the UCR set by an insurance company does not mean that you are charging a higher amount than doctors in the area. Instead, it just means that you are charging more than the percentile-reimbursement level for the insurance company that you are working with. When reassessing and adjusting UCR fees for your dental practice, you should pay attention to the UCR schedule for your zip code.
Once you have compared your fees to other practices in the area, you can use that data to implement changes in your practice. For example, if you think your fees aren’t off by much, say, only 10% on just the top 10% of services you offer, that can still add up. You could still be losing $50,000 a year from what seems like a negligible error percentage. Additionally, if you charge $100 for a procedure and the insurance company reimburses it at $75, you will only be reimbursed $75, because insurance companies will pay the lower of the two numbers! This highlights why you need to make sure your fees are in line with the market!
Work with the Right UCR Fee Adjustment Partner
Whether you’re anxious to adjust your current UCR fees or struggling to meet your practice’s goals, our experts can help. It’s essential that you partner with someone who knows the dental market and understands how to turn a great practice into a great and profitable practice. Contact our team today by calling (410) 710-6005. We look forward to working with you to make your practice a more profitable place.