If you\u2019re glass-half-full person there\u2019s reason to be hopeful. Perspective being what it is\u2026the changes in dental insurance coverage could signal needed hope.<\/p>\n
An industry survey indicates that a shift coming. It has to do with the perceived alignment between medical and dental insurance providers.<\/p>\n
This \u201cconvergence\u201d as it\u2019s being called, follows the \u201cbroad changes\u201d in health care. According to a DentistryIQ article the trends are…<\/p>\n
\u201c\u2026away from costly fee-for-service models and toward coordinated care, value-based reimbursement, and more streamlined, affordable, and prevention-based experiences.\u201d <\/a><\/p>\n The latest survey conducted by the firm West Monroe Partners reveals what\u2019s driving the changes for medical and dental insurers. A few dominant themes emerged.<\/p>\n One-third of survey respondents stated a 90% drop by 2025 for the payer\u2019s market share (from 97% in 2020). One in five see a drop below 85%.<\/p>\n 54% are expected to partner or bundle (46%) benefits with a medical\/health insurer by 2025. Stay-competitive strategies include:<\/p>\n Though noteworthy, a solid plan for bundling medical\/dental plans is lacking. Technology to administer a \u201cunified product\u201d is slowing the pace (36% in 2020 cite technology as a barrier – down 10% from 2018).<\/p>\n Though the number of US adults visiting the dentist has dropped (37% did so in 2019), COVID-19 is believed to keep a lid on that statistic. Still, optimism emerges that as there\u2019s a perceived shift away from standalone dental plans a majority see a merger between oral health and overall health.<\/p>\n The health integration is supported by a variety of factors:<\/p>\n These combined with the integrated approach (general health-oral health) could lead to a higher amount of overall dental visits.<\/p>\n 48% see this trend growing between 2020 and 2025. The individual market follows with 63% anticipating growth.<\/p>\n COVID-19\u2019s impact on employment could sway the numbers a bit. The results could also challenge employer-sponsored plans shifting employees to individual plans.<\/p>\n Bottom-line: any shifts can place unprepared dental plans at risk. Even so, providers and payers could be faced with opportunity – giving patients lower costs through coordinated, value-based care.<\/p>\n Each have to do with how dental insurance coverage is available to you (as a provider) and your patients.<\/p>\n The systemic connection between oral health and overall health is being made clearer as dentistry is bundled with medical coverage. That said, coding and claims submission knowledge and resources are essential.<\/p>\n Two claim filing strategies can help navigate the changes and innovations in coverage.<\/p>\n Implement the right system and you can help your patients consistently maximize their insurance coverage. Patient relationships will improve as you become their insurance advocates.<\/p>\n Looking for an alternative to the traditional insurance provider relationship? A dental membership plan might be an effective solution for you and your patients. Explore this content to discover the why-and-how:<\/p>\n What Is a Dental Membership Plan and How Can It Improve Your Revenue Cycle?<\/a><\/span><\/p>\n Check out these insurance themed resources also:<\/p>\n How to Bill Medical Insurance for Dental Procedures<\/a><\/span><\/p>\n Why You Should Take Advantage of the Opportunity to Bill Medical Insurance for Dental Procedures<\/a><\/span><\/p>\n Planet DDS\u2019s Denticon Dental Practice Management Software<\/a><\/span> helps you standardize those systems that also help you assist your patients with their insurance benefits.<\/p>\n The Denticon Dental Dashboard<\/a><\/span>, Dental Bookkeeping<\/a><\/span>, and Dental Charting Software System<\/a><\/span> can centralize tasks and workflows<\/a><\/span> (including insurance reimbursements) and grow your practice.<\/p>\nAnd the survey says\u2026<\/h2>\n
Dental payer territory is shrinking<\/span><\/h3>\n
Dental payers are focused on staying competitive<\/span><\/h3>\n
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\u201dConvergence\u201d pace is increasing<\/span><\/h3>\n
Growing consumer demand<\/span><\/h3>\n
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Increasing availability of employer-sponsored dental plan memberships<\/span><\/h3>\n
The general consensus about changes in dental insurance<\/h2>\n
Consider that there are two primary paths the changes can take <\/span><\/h3>\n
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Confirm that your dental practice team is <\/span>trained, knowledgeable, and skilled<\/span><\/a><\/span> in claim filing<\/span><\/h3>\n
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Embrace the changes in dental insurance and improve your billable opportunities<\/h2>\n