Negotiating Insurance Contracts & Fees

Insurance companies make it difficult for those under their contracts to understand how to get the most profitable rates. This can prove to be challenging to dental professionals. Many dental offices will sign contracts with insurance companies that allow greater benefits to the patients under those insurance companies at their dental clinic. There are several benefits to doing this, one of the greatest being an increase of patient loyalty and satisfaction. 


Because of this, you may find yourself having to deal with insurance contracts at some point at your practice. Luckily, despite the complicated nature of insurance contracts, there are several steps that you can take to simplify the process for yourself and for the rest of your team, while still finding the deal that will suit your practice and your patients best. 



Of course, all is not lost if you don’t already have a relationship built. And maybe you don’t want to take the time to build it before you attempt to negotiate for a better deal. It is recommended that in those cases, it is best to go with “option B” — using a third-party company to help you negotiate for the best deal. But, if you do exercise this option, be careful — insurance companies stay one step ahead of the game. They often develop policies or methods to avoid giving third-party companies like MDent the necessary information that is needed, or refuse to work with them entirely. 


Make sure to approach third-party help as working “with” you, rather than “for” you. Stay directly involved with your insurance company. Use the third-party to help with negotiations, but don’t rely entirely on their service or use them as a middle man. The communications should still come from you.


No matter which route you decide to take, there are two very important factors that you must keep in mind. Forgetting to account for these two things will make the transition period much harder to deal with, not only for your patients and your bottom line, but also your staff too. 


Keep These Things In Mind When Negotiating Fees With Insurance:


  1. Keep patient experience in mind. Know that some insurance companies penalize practices for trying to leave a direct contract and rejoin under an umbrella or indirect one. Warn the patients affected by the contractual changes ahead of time, especially those who are returning patients to your clinic. If you don’t, the insurance company might send them a letter in the mail, urging them to choose a different clinic instead. Keep one step ahead and communicate clearly with the affected portion of your client base at the start, so that they have the right information and aren’t scared off by this tactic. 
  2. Keep your team’s experience in mind, too. It is crucial to support your team through transitional periods, especially one that can be as hairy as insurance contract changes. You, as the business owner, understand the bigger picture — but your team needs to understand it as well. Communicate closely with them, and make sure they are committed to the same big picture outcome that you are. Involving them with decision-making, and ensuring that they are correctly supported and encouraged will prepare them for the transition as well as keep them motivated, even during the most hectic phases.