Dropping network participation is often considered an overwhelming task by many dentists due to the fear of losing customers or money. In 2019, around 80% of Americans had a dental plan. In 1994, the figure was a meager 43%. The growth of dental benefits drastically changed the landscape of the practice, bringing in a massive inflow of providers into dental networks to attract and retain insured patients.
On average, providers are part of 8+ dental networks, and nearly half are affiliated with 11+ networks. Simply put, it is no longer a new thing to be a participating provider since participation only improves the playing field.
How to Drop Network Participation in Dentistry?
Dentists drop dental participation to increase revenue. However, transitioning away from heavy insurance participation may seem daunting. The following 4 factors will help you gather the relevant data and speed up the process.
Collect Contract information for all your in-network plans
This step is crucial and will involve scrutinizing each plan, its updated fee schedule, and the possibility of renegotiating the fees. It is also essential to know when the contract will be renewed and the notice period required (some require a six-month notice) before the network can be left.
Know your Active Patient Count
Before knowing how the transition will affect your practice, it is critical to know the active patient count. This includes all the patients who have visited your office in the last one and a half years. Once you have calculated your active patient count, determine how many participate with each insurance plan. This will help you understand the potential attrition you could lose with a network change.
Know your Cancellation Rate
Sometimes, dentists drop one or more insurance contracts because their schedules seem “overbooked.” Keep in mind that many offices experience high cancellation rates, which can disguise an underlying schedule issue by filling it with appointments that might get canceled. The ideal hygiene cancellation rate is 8% or lower, translating to less than one patient per column per day. Moreover, doctor cancellations should lie below 1%. For example, if your cancellation rate is 11%, take appropriate measures to reduce or make room for extra patients to compensate for the canceled appointments.
Assessing cancellation rates is integral as it will help you see if you are overbooked with many patients or if you have a masked cancellation issue that will probably worsen if you drop networks.
Meet Patient Expectations
Irrespective of your fees, patients inherently see you as an expensive option when you are out of fees for service or network. Some patients will be willing to pay more, but it typically comes with the expectation that your service will be exceptional compared to the dentist down the block who is in-network.
If your existing service is already top-tier, or if you are willing to go the extra mile to improve the level of provided care, then dropping networks may be a good solution.
Conclusion
Dropping network participation in dentistry is viable, provided that it is done for the right reasons, such as those mentioned above.
Additional Sources:
https://www.actdental.com/blog/the-5-things-to-know-before-you-drop-a-dental-insurance-ppo
