A low reimbursement rate from the dental insurance billing affects your capacity to provide for your patients’ needs. It can take a while before you can afford a specific type of equipment, for instance. When this happens, it’s time to negotiate for a higher reimbursement rate so you can have enough income to support your clinic and staff.
In Utah, the same problem plagues the dentists. The application of the dental fee program has flaws, as there’s no fixed amount provided for the dentists. Some might receive reimbursements of up to 15% of their usual fees, but others generally receive only 40 to 50%. Such disparity causes problems in obtaining proper pay from Medicaid and private insurance companies.
Medicaid Privatization: An Aggravating Factor
Medicaid, the primary insurance program from the government, has privatized its dental problem, which became effective September of last year. Jason Horgesheimer, president of the Utah Academy of Pediatric Dentistry, disagreed against this project. He has argued that privatization can further decrease the benefits patients receive, especially children from poor families who need dental care.
This can affect your practice if it’s part of the Medicaid program. You might have to think about dropping out and maintain membership with your current Preferred Provider Organization (PPO). This will make it necessary to talk terms to increase reimbursement rates with your provider.
Negotiating for Fairer Reimbursements
Consult an agency that has experience in transacting with different insurance companies to help you negotiate. Their experience will come in handy, as you look for a deal that will let you support your clinic’s needs satisfactorily. Specialists will study the processes in your practice to determine the amount it requires to maintain acceptable facilities and obtain acceptable rates.
A Continuous Drive for Improvement
Once you achieve higher rates, this won’t be the end of the negotiation. You’ll have to review them every year to determine if they’re enough for your clinic’s growing needs. Check out how you can ask for better benefits from knowledgeable resources.