Frequency: How Dental Insurance Companies Eliminate Procedures, or Reduce Payment

The My Practice My Business Dental Podcast

Think about it, dental insurance companies have eliminated certain codes from their payable lists. From anesthetic to PPE, and from acid etch and bonding to build-ups. It's all about frequency. What do I mean? It's simple, they have algorithms that point to procedures we do all the time, and they realize that if they can alter just one thing, if they can eliminate payment on one particular procedure that is done often, that will save them millions of dollars over the course of one year. It's really brilliant business on their part, but it's negatively affecting our dental practices from being profitable. We need to stop it, and that's why Tracy and I are on Utah's Capitol Hill trying to pass bills that will protect both patients and dentists from downcoding, bundling, and preventing us from charging for services we provide to our patients. What are you doing to help out your dental association in preventing what the ADA says are fraudulent acts from third-party payers?

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