We didn’t want coverage to be the reason our patients didn’t move forward with treatment, which is really beneficial to their overall health, not just their oral health. We believe it’s essential to provide quality care without barriers. —Kevin D’Andrea, DMD
I practice alongside my father and two cousins so it’s really a family-oriented practice. We really try to bring that to the table with our patients, making them feel comfortable and part of our dental family.
Dr. D’Andrea
OVERVIEW
While thinking about how to reduce PPO write-offs and eliminating payers that were not beneficial to the practice or patients, Dr. D’Andrea began researching dental membership plans.
This year, he and his cousin will buy the 30 year old practice that their fathers have built. Implementing a membership plan was crucial to their long-term vision and the success of their practice.
CHALLENGES
Limitations in coverage and third party decision makers having a say in patient treatment was becoming a bigger issue. When the 2020 pandemic hit, many more patients lost their jobs and their employer-provided benefits.
We knew we needed an option and I had read in a magazine the real benefits of a membership plan. I was especially interested in having patients that were dedicated to their oral health. And being able to treat them without having insurance companies tie our hands together. I don’t like to dictate treatment based on what their insurance is going to cover, it’s a disservice to the patient.
Dr. D’Andrea
De-stressing the administrative team and eliminating time associated with insurance providers. Limitations in coverage, prior authorizations and scheduling conflicts were all negatively impacting the practice.
It’s a huge burden on our front desk with all the insurance games. Nothing is cut in stone and there’s a lot of grey area. Day in and day out, they are trying to put a dent in the insurance paperwork and it’s never ending. The time and the headache is not worth it.
Dr. D’Andrea
Membership Plan Goals:
1. Reduce PPO write-offs and eliminate providers that did not reimbursement enough or did not cover the necessary care.
2. Develop another patient base to build and grow their name, reputation and practice.
3. Better serve older residents in the community that do not have dental coverage.
RESULTS
Prior to their membership plan they were far below the national average for perio charting. Now they are able to diagnose earlier because those patients come in regularly allowing for better treatment options.
Patient retention has improved because membership patients are invested in their oral health. Treatment acceptance continues to increase as cost confusion is removed allowing the dentist-patient relationship to flourish.
New opportunities have presented themselves for easy membership growth like employer managed plans. Dr. D’Andrea will be speaking with small business owners in his area to develop and grow these plans.
It’s not just about the reimbursement, having the membership plan, we feel patients are more dedicated to the practice. So when we invited them back, we had an option to present to them. Especially those that had lost their benefits. Being able to continue our patients on a good path with their oral health was incredibly important to us.
When I learned about Plan Forward it seemed like they had a great team. And I knew they had a dental background with real practice experience. They knew what a dental practice was really like, that made me feel comfortable. Then, the meeting was the icing on the cake with them providing all the benefits and being very engaged the whole way. Every question was answered quickly, it was a very good feeling.
Kevin D’Andrea, DMD
