Dental Insurance: Why We’re Going Out of Network
Written by Dr. Adrienne Hedrick
As previously announced, Longmont Dental Loft will be out of network soon with all dental insurance providers, including Delta Dental, effective January 1, 2024. We’ve made this decision because dental insurance offers less value than it once did and has negatively impacted our practice over the years. In fact dental insurance is in decline and there’s a trend where more and more dental practices are going out of network.
Please continue reading to learn more about why we’re going out of network and why it’s in our and our patients’ best interests to do so.
Why We’re Going Out of Network
The primary reasons we’re going out of network with dental insurance providers are the following:
- They’re decreasing benefits and increasing denials.
- They’re often not transparent about how much they will reimburse and what they will reimburse for.
- They dictate how much we can charge, and it’s never enough to keep up with inflation.
The Inflation Problem
Over the past ten years, Delta Dental of Colorado (our sole current in-network provider) has allowed us to increase prices by an average of just ~1%, which does nothing to cover our rising costs each year for equipment, supplies, and employee wages.
The following example illustrates this issue:
A particular position that paid $30,000 a year in hourly wages in 2013 would now be worth $39,383 in 2023, which is a 30% increase over ten years when adjusted for inflation.
Alternatively, because we can charge only 1% more for procedures in 2023 than we did ten years ago, that means a procedure we performed and charged $30,000 for in 2013 is only worth $30,300 in 2023. That’s a mere $300 more.
We can’t maintain a high standard of patient care without charging fair prices and adjusting them for inflation, and the only way to do this is to go out of network.
The Issue of Fair Market Wages
The need to pay fair market wages is not unique to our industry; however, ineffective insurance policies make it virtually impossible for us to offer them to our dental hygienists. Furthermore, paying hygienists their worth is especially critical because there is currently a major dental hygienist shortage, and retaining them and attracting new ones without competitive pay makes it even more difficult to reverse this deficit.
An Issue across the Country
These industry challenges extend beyond Longmont Dental Loft as it’s affecting dental practices across the nation. Our biggest concern is that if dentists don’t take a collective stand by gradually going out of network, then the large dentistry corporations will take advantage of struggling private practices by buying up as many of them as possible. They’ll have no recourse, and we’ll be left with a market of mostly large dentistry corporations that sacrifice quality instead of the small private practices that focus on high-level care.
Summary
Ultimately, going out of network will benefit our patients as there are many advantages to seeing an out of network dentist. As a result, they’ll receive better care, more transparency, and the freedom to choose the most effective treatments and procedures. We look forward to implementing these changes and believe they will pave the way for a brighter future for the industry as more dentists do the same.
