Many dentists across the U.S. have become frustrated and fed up with the dental insurance industry, citing low reimbursements and delays.
"What frustrates me is the lack of consistency in dental insurance reimbursements for certain procedures that we perform," said Eugene Bass, DMD, a dentist in New York City.
Even when procedures are covered by a patient's plan, there are some insurance companies that try to delay payment to dentists.
"My main frustration is dental insurance companies that delay and throw hurdles [by] requiring detailed progress notes and redundant narratives for a procedure that is clearly covered by [patients'] insurance," said Eric Mintalar, DDS, a dentist in Brooklyn Center, Minn. "It is frustrating and it doesn't appear to be improving."
The problems dentists face with insurance, along with increased business costs, is causing burnout throughout the industry.
"Dental industry burnout is a direct result of the increased cost of running a dental business in the post-COVID climate and the inadequate insurance reimbursement that has failed to not only keep up with inflation but has, in many cases, not increased meaningfully for over a decade," said Kai Weng, DDS, a dentist in White Marsh, Md.
Being a solo practitioner is becoming more and more difficult, and there is a case to be made for group practicing when it comes to the business side of dentistry. Those who choose to stay solo may find it even more difficult in the future.
"It's harder to be a small practice than in the past for many reasons, including reasons that have nothing to do with dental insurance," said Michael Adelberg, executive director of the National Association of Dental Plans, adding that it increasingly makes sense from a business perspective to join a group or DSO. "For the people who are choosing not to go that route, it might get harder for them. I don't doubt that."
Dentists are not the only group that has problems with the dental insurance industry. According to a study from Synchrony, 58% of consumers feel like dental insurance is not affordable. With more than 8 million people being disenrolled from Medicaid, that percentage could rise even higher.
The way out, Dr. Weng told Becker's, is for dentists to change their relationships with insurance providers. "By moving out of network, one can be reimbursed properly for their work, lower their volume and spend more face time with their patients, and provide better benefits, pay and environment for their team."