The Journal of the American Dental Association
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J Am Dent Assoc, Vol 136, No 2, 204-209.
© 2005 American Dental Association

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PRACTICE MANAGEMENT

The ins and outs of dental insurance



RONALD INGE, D.D.S.

Background. In the past three decades, dental insurance has become a permanent fixture in the delivery of dental services. Some would argue that this has not been good for dentists. However, none will dispute that it is here to stay and that dentists must make some very important decisions in their practices with regard to dental insurance. This article will explore some of those decisions and offer some guidance on how to decide wisely.

Conclusions. Dental insurance now is a permanent fixture in the delivery of dental care. Each dentist must decide if participation with a dental insurance company is in his or her best interest. To make this decision, a dentist must have as much information as possible to evaluate each specific dental plan. If a dentist does decide to participate, the dentist must know the rules.

Practice Implications. Participation with a dental insurance company may influence the dentist-patient relationship. Dentists must be prepared to answer the question, "Why do I need this service if my dental insurance does not cover it?" Non-participation with a dental insurance company may result in a reduced number of new patients.

Key Words: Managed care; contract; claim submission; claim review







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