This blog post is a reaction to the article “You and your dentist may have a bone to pick with Delta Dental” that appeared in the Seattle Times. Read the full article here.
Delta Dental is arguably the biggest dental insurer there is. From a provider’s standpoint, Delta Dental has the upper hand over new and old dentists and has for some time. If you’re not in-network provider with Delta Dental, they will issue any claim payment directly to the patient only. Obviously this can put dental offices in a situation where they charge a patient upfront or chase them for payment. In-network dentists get reimbursed directly by Delta Dental but we are subject to all sorts of limits, rules and cuts to benefits, year after year. From an administrative and billing standpoint, Delta Dental can be easy to work with due to quick electronic eligibility, claim submission and payment, but any cost saving efficiency is lost due to their efforts to stall or deny claims. Delta Dental is not the worst insurer (United Concordia wins the medal for being the worst dental plan) but Delta Dental is up to something and we’ve taken notice. It is interesting executive salaries are increasing as claim payments towards seem to be dropping.
Delta Dental is not the only insurer guilty of such tactics but it seems as though they are getting worse. Most dentists’ dream of the day they can drop Delta Dental altogether because of new limits, cuts in benefits and stalling of payments have gotten out of control. Dentists’ already take a cut of their normal fee for services in order to be a Delta Dental provider. Delta has improved and streamlined a lot over the years but only to help their bottom line. We still spend hours on the phone trying to adjudicate basic dental claims. Lastly, employers and human resource departments need to understand the real implications regarding dental benefits for their work force. Delta Dental claims it is the employer that determines the level of coverage-good or bad, not Delta Dental. It is our opinion that is partially true and that employers do not really understand the quality of plans. Executives, CEOS etc, could easily afford dental treatment without insurance but the often have top notch plans that are not offered to the regular employees. The point is some employers potentially have a blind spot when choosing employee benefits.
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