Are you looking to create revenue growth in your practice? Truthfully, who isn’t? I’m a fi rm believer in the concept of “working smarter, not harder.” Unfortunately, I’m seeing dentistry move away from this and more toward a trend of seeing more patients to create growth. The truth is that the smartest revenue growth you can create doesn’t require any additional patients. One way is to implement medical billing in your practice.
Medical billing can provide a revenue boost from the patients you are already seeing. This happens in multiple ways: 1) medical insurance often has higher reimbursement rates than dental insurance; 2) medical insurance often pays for procedures that dental insurance doesn’t; 3) using medical insurance leaves dental insurance maximums intact; and 4) medical insurance opens new treatment options to our practice.
Dental insurance does not properly compensate dentists for their time. This is especially true when it comes to exams. In fact, I would go as far as stating that dentists undervalue their time, expertise, and how much they accomplish in a patient exam. Let’s say the average dentist values their production at $600 per hour. Using that logic, an exam that you spend 10 minutes doing should be valued at $100. This type of exam typically has a reimbursement of $30-$40 through dental insurance. In my experience, we have seen reimbursements range between $80-$170 for the equivalent exam through medical insurance. Now imagine how many exams you do per year and if you were able to increase the reimbursement.
Medical insurance also pays for some procedures more readily than dental insurance. The fi rst that comes to mind is 3D CBCT imaging. While dental insurance is just starting to reimburse for CBCT imaging, nearly all medical carriers allow benefi ts for this. Another example would be the plan frequency limitations in dental insurance. Most commonly, dental carriers place frequency limitations on exams and radiographs. Such limitations don’t exist with medical carriers. So those exams and radiographs that you typically write off can be covered by medical insurance.
More importantly, we know that dental insurance maximums have pretty much remained stagnant since the early 1970s. To me, this is even more reason to leverage medical insurance in the dental practice. The typical patient has an annual maximum of $1,000. About $250-$350 of that will be gobbled up by routine prophy, exams, and x-rays. That leaves very little to go toward the restorative dentistry the patient may need. We have found that using medical insurance for exams and x-rays (medical won’t cover the prophy) leaves more benefi ts available for patients to complete their restorative treatment.
Get Educated
The success of medical billing in your practice will vary by plan, carrier, and state. Like any insurance, there are deductibles, copays, and network status that will affect your reimbursement. Medical insurance is based on the concept of medical necessity—if a procedure is deemed medically unnecessary, then you will not see reimbursement. All this said, our practice has seen tremendous success through medical billing.
Don’t dismiss medical billing as something that doesn’t work. Get some education to better understand the caveats and how to properly and ethically utilize medical insurance in your practice.
Dr. Tarun Agarwal is a full-time practicing general dentist who deals with the same issues all practitioners face—overhead, diffi cult patients, ups and downs of private practice, and team management. Despite his practice being contracted with insurance, he has built a successful practice focused on clinical excellence, customer service, and allowing patients to choose optimal dentistry. Dr. Agarwal is also the leader of 3D Dentists, which advocates for a practical approach to growing your dental practice. Email info@3D-Dentists.com.
