Introduction:

Imagine offering your patients a treasure chest filled with dental benefits, only to find that most of them barely peek inside. Dental insurance, while designed to promote oral health, often remains an underutilized asset. Let's delve into the numbers and uncover the hidden opportunities for dental practices.

The Underutilization Phenomenon:

Despite the availability of dental insurance, a significant portion of benefits go unused annually. According to the National Association of Dental Plans, only 2.8% of individuals with a PPO plan reach their annual maximum benefits each year. Other sources indicate that annual maximum utilization averages 5.7%. This suggests that many patients are not taking full advantage of their coverage and this screams opportunity for all dentists nationwide!

Utilization Rates: Adults vs. Children:

Dental care utilization varies across age groups. In 2021, approximately 50% of children and seniors visited a dentist, compared to only 39% of adults aged 19-64. This disparity highlights the need for increased awareness and encouragement for adult patients to seek regular dental care.

Understanding Loss Ratios:

The dental loss ratio (DLR) represents the percentage of premium dollars spent on patient care. In Massachusetts, large group dental carriers have an average DLR of 79%, while individual and small group carriers average about 68% according to National Association of Dental Plans. These figures indicate that a substantial portion of premiums may not directly contribute to patient services.

Deductibles and Patient Costs:

Most dental insurance plans include an annual deductible, commonly around $50 per person. This means patients must pay this amount out-of-pocket before their insurance begins to cover services, potentially deterring some from seeking care.

Opportunities for Dental Practices:

1. Educate Patients: Inform patients about their benefits and encourage them to utilize preventive services, which are often fully covered.

2. Promote Regular Visits: Highlight the importance of routine check-ups to prevent more significant issues and expenses down the line.

3. Consider In-House Membership Plans: For patients who underutilize their insurance, in-house plans can offer a cost-effective alternative, providing predictable expenses and comprehensive care.

Conclusion:

Dental insurance holds untapped potential for both patients and practices. By understanding and addressing the underutilization of benefits, dental professionals can enhance patient care, improve practice efficiency, and unlock new avenues for growth.

Benjamin Tuinei

Founder - Veritas Dental Resources, LLC
Phone: 888-808-4513

Services:
PPO Fee Negotiators | PPO Fee Negotiating | Insurance Fee Negotiating
Insurance Credentialing | Insurance Verifications

Websites:
www.VeritasDentalResources.com | www.VerusDental.com