Since well before the Affordable Care Act, insurance has been a very contentious issue for practice owners. There is always a question of whether in-network PPO participation is worth the tradeoff of jumping through the hoops to gain new patients.
The Truth Is… It’s OK to be in- network but you may be missing significant areas of growth and opportunity you haven’t even considered.
Insurance participation can be both an asset and a viable avenue in which to grow your practice. But getting patients in the front door is easy. Keeping them is quite another.
Recently, I talked with a dentist who claimed his practice got 80 new patients each month through insurance participation. What doctor wouldn’t like that? But, he wasn’t keeping them.
Get out your calculators! Our benchmarks indicate a typical dentist can adequately serve 1700 patients. If a new practice retains 80% of these 80 new patients they receive each month, by the end of the first year, an additional 768 patients would be part of the active patient base. At this rate, in just a short year and a half, the practice should meet capacity.
Unfortunately, this practice is not retaining these patients and the reasons are multi-faceted. To put it simply, the practice isn’t delivering the type of value and customer service his community demographic demands.
Industry reports indicate that as many as 60% of new dental patients don’t return to the same practice a year later. They may visit once or twice, but something happens (or doesn’t happen) by the end of the first year.
So, what about the networks you participate with? Have you looked closely at the networks, plans and employer demographics within your practice? If not, you should. Maybe it’s time to separate the wheat from the chaff.
Do certain network clients clog up your schedule with missed appointments, bad debt, or don’t complete diagnosed treatment? Are these same people the ones who put off getting that crown you diagnosed two years ago, yet feel comfortable calling you late at night, on the weekend, or when you are just about to carve the Thanksgiving turkey?
Understanding who says “yes”, pays on time, and is compliant is your biggest network asset.
Every network is different and only a thorough analysis will identify which insurance options are best for your practice.
There are 3 often over-looked opportunities you may be missing with insurance networks.
1 – Use networks as filters for demographics.
Because of their individual profiles, some networks may be a bad fit for your practice, while others might be better for growth and opportunity. Look at their populations to see how they fit with your practice strengths or holes where you need to build your patient base.
2 – Insurance claims are your strongest communication.
Listing and submitting every single service you provide on an insurance claim becomes part of the healthcare communication record. Regardless of whether you are reimbursed for a service, you MUST submit each procedure to send a message to insurance companies that your practice provides comprehensive care. Not only is this your best communication to these insurance companies, but submitting all procedures on claims closes a significant documentation gap that both reduces your malpractice risk as well as provides a powerful tool at contract re-negotiation time. If you aren’t set up to do ALL these things, your practice is losing money and could be at risk if you are audited.
3 – You must collect at the time of service.
Not only are you contracted to collect patient portions at the time of service, but prompt and accurate billing and claims processing is the only way to receive timely payment and increase revenue. If your billing system or insurance policy is out of date or otherwise doesn’t allow you to collect in a timely manner, your practice will incur additional administrative costs through billing, account and claim follow up, and collections that can delay your cash flow and substantially increase overhead.
Vero3 clients are trained to make insurance work for their practice. We teach them how to tap into opportunities with each provider and policy and set up systems on the front end to eliminate waiting time and unexpected costs and overhead. Our clients repeatedly demonstrate that they provide top quality care and superior customer service while working with almost any insurance network.
If you believe you may be missing growth opportunities, call Vero3 for a no-strings consultation. We’ll help you rethink your insurance strategy to increase profitability and attract more of the types of clients you desire.