Increasing annual maximums, more transparency from insurance companies, and reimbursements keeping up with inflation are three aspects of the dental insurance industry that dentists would like to see changed.
These six dentists recently connected with Becker's to share how the dental insurance industry could be improved upon.
Note: Responses were lightly edited for clarity and length.
Question: What is one change that you would make to the dental insurance industry to improve dentistry for dentists and/or patients?
Shane Berger, DDS. Dentist at Berger Dental (Denton, Texas): Dental insurance policies should be forced to publish/provide exact reimbursement amounts per procedure code for both dentists and patients instead of stating they pay based on [a usual, customary and reasonable fee schedule]. They fail to mention what percentile UCR the policy is based on, and if you ask a customer service representative they have no idea what you're talking about. There are only two companies that I have seen that state in writing on their summary of benefits what percentile their policies are based on.
Vu Dang, DDS. Dentist at Dental Care T Palmer Ranch (Sarasota, Fla.): One thing that I would change is the annual maximum coverage amount. Each insurance company has its own amount in different plans, but the annual maximum coverage amount has been the same for decades. I have often seen $1,000 or even lower.
David Graham, DMD. Dentist at David L. Graham, DMD (Pittsburgh): The maximum dollar benefit for patients has historically been low, with little increase over the past 40+ years. The average maximum benefit was $1,000 to $1,500 for decades. It should be raised to $7,500 or more if it were to keep pace with inflation over that time period. This is the biggest factor limiting insured patients from obtaining optimum care.
William Hunt, DDS. Dentist at William Hunt, DDS PA (Forest City, N.C.): A good change would be establishing an annual review of fees paid to providers. As supplies and other expenses increase, there needs to be a way to help offset this without the provider losing more income.
Michael Perpich, DDS. Dentist at Northland Smiles (Deerwood, Minn.): Two changes I would like to see are annual inflation increases in reimbursement and annual maximums. Electronic remittance would be awesome.
Charles Wolfe, DDS. Dentist at Wolfe Dental Spa (Easton, Pa.): I would like to see better reimbursements with higher limits than what was set back in the 1970s and hardly increased to keep up with inflation. Limits should be more in the $4,000 to $5,000 range and not $1,500 to $2,000 range from 50 years ago. Also direct payment to all dentists, whether in network or not.