More than one-third of dentists have dropped out of at least one insurance network so far this year, according to the American Dental Association.
But what is causing dentists to take this route? A separate survey from the ADA showed that almost every dentist dropping networks cited reimbursement amounts.
Over 98% of respondents in the poll said that reimbursement was a reason for them dropping a network. The second most common reason was the administrative burden, at 57.3%.
Harry Papadopoulos, DDS, MD, a dentist in Indiana, doesn't participate in Medicare but is a part of the Medicaid program. He believes that the burden is only growing, especially on solo practices.
"Timely reimbursement has not been a problem, which is a big plus, but fees have been chronically low even with recent increases," Dr. Papadopoulos told Becker's. "Indiana had a 10% increase in fees recently but that does not make up for lack of fee increases in 15 years. Recently, commercial insurance companies have gotten involved with Medicaid in my state, causing confusion and added work for my staff trying to verify benefits and collect reimbursement thereafter."
While higher reimbursement rates are something that every dentist wants, there are other meaningful changes that providers believe would help, said Shane Berger, DDS, a dentist in 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]," Dr. Berger said. "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."
The trend of dentists dropping networks is not coming out of the blue. In July, the ADA asked dentists if they were planning to drop networks this year. Almost 25% said that they already had at the midway part of the year, with nearly 27% more considering the move.
If dental insurers are unable to keep up with the wants and needs of dentists, providers likely will continue dropping out of their networks.