Insurance Plans – Can you Really Drop Them?

Is a fee-for-service practice even possible? Or is it just something that all us consultants make up to get you to buy our “stuff”?

If you have been around for a while, you might remember that we used to market our New Patient Workshop on the basis of teaching you (dentists) how to drop insurances and have a fee-for-service dental practice.

And again, if you’ve been practicing for a bit, you may have noticed that we dropped the “fee-for-service” practice as a big selling point around 2006.

Why?

Well, people just weren’t responding to the idea like they used to! So, we had to change.

At the time, it got me thinking – what happened?  Why weren’t we getting traction with what seemed to be a great message anymore? Were dentists not interested in a full-fee practice? Did they love writing off 40% for insurance plans?  Obviously not, but something was going on, so I spent some time talking to people like you – dentists in private practice.

(Related: Patients in My Area Are All Insurance-Driven)

What did I find?

Put simply, the idea of a fee-for-service office was of course “great.” But 8 out of 10 of the doctors I spoke with said it was impossible to achieve. There was “no way” to drop insurances and still have a successful office.

In other words, the average dentist had become apathetic about the subject. I could have put “would you like to learn how to levitate” on my promotion and had the same result: “Sure, sounds great, but it’s obviously impossible!”

And funny thing, while we market the service differently now, beyond updating the curriculum to stay cutting edge with our advice, we really didn’t change the basic concept.  It still teaches dentists how to attract more fee-service patients.  They just don’t realize it’s possible until after they attend the workshop!

Which brings us to last year.

Many dentists who wouldn’t even entertain the idea of dropping a plan (because they couldn’t afford to), all of sudden found themselves seeing few or no patients due to COVID shutdowns.

And those insurances which they “couldn’t live without” weren’t helping them all that much now.  For many of our clients who still had some plans, they now had time to settle down (beyond doing emergency treatment) and actually look at the numbers.  They had time to think – hard – about whether doing a $600 crown (when their full fee was $1,400) was really worth it. And many decided it wasn’t!

And to a degree, we’ve seen this play out in the industry. MGE clients normally drop most of the low-reimbursement plans, and many clients are fully fee-for-service, but those shutdowns gave birth to a new renaissance in the idea of having a private, fee-for-service office!

(Related: Collecting on Past Due Accounts in Your Dental Practice)

To facilitate this movement, we created what we call the “Plan Analyzer.”

Plan participation (and percentage of revenues) varies from office to office. Maybe you just have one with few patients and it’s easy to drop.  Or you might find that 80% of your practice is PPO or HMO.

In cases like the latter, dropping plans is normally a gradient process – one at a time – worst reimbursing or least revenue-generating first, then the next worst, and so on.

(Related: What to do When Patients Say They Only Want to do What Insurance Covers)

The idea behind the Plan Analyzer was to provide a way for you – the doctor/owner to analyze how much it’s costing your office to participate.  But, it gets even better.

Generally speaking, and we’ve had plenty of clients go through this process when you drop plans, you’re going to lose an average of 30% of the patients involved.

Sure, there are ways to minimize the damage.  And I’d start by:

1. Being able to generate more fee-for-service patients, with the MGE New Patient Workshop and
2. Being able to sell effectively, and have an organized, well-staffed practice with excellent customer service (see the MGE Power Program),

But all in all, we’ve seen the average run about 30%.

To be clear, this isn’t a 30% loss of revenues or production – but a 30% loss of patients on the plan you’re dropping. In fact, as you’ll see when you use the analyzer, most practices actually make MORE profit after losing that 30%.

So, in addition to estimating how much you’re losing by participating, this Plan Analyzer also tells you HOW MANY PATIENTS YOU CAN AFFORD TO LOSE WHILE MAINTAINING THE SAME LEVEL OF PROFIT!

I did that in ALL CAPS as that’s kind of a big deal.  Imagine you lose X amount of patients by dropping a plan and you’re charging your normal full fee. You’re working less, yet making the same.

And I’m not only telling you this is possible – I’m telling you we have clients doing this all the time!

In any event, I recommend you try this on for size.  You can download the Plan Analyzer here.

I’ve also included the instructions on HOW to use it, along with a video walk-through where I provide a bit more insight!

I hope you find this useful.  I truly wish you the best and if you have any questions, you can email me at jeffb@mgeonline.com.