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Message from the President – PPO and Discount Plans

Founder and President - Steve Thorne

Founder and President - Steve Thorne

Last year PDS experienced a 45% increase in PPO dental plans. In the first quarter of 2009, we experienced even faster growth. In the coming decade, two types of dental plans are expected to continue to grow: PPO’s and Discount Dental plans. They are essentially the same thing whereby the insurance carrier asks our affiliated dentists to take a discount to their “normal” fees, and then they will refer patients. The main difference is who pays the fee. With PPO’s, the insurance plan pays the fees. With Discount Plans, like our My Smile Dental Plan, the patient pays. Our incredible service, modern facilities, and strategic marketing, combined with the fact that the local competition is not as proactive as we are; means that most of our affiliated practices are sure to get more PPO & Discount patients coming to them.

The great thing about Discount Plans is that they are very easy to administrate. Patients come in, and if they need treatment, they pay the fee listed on their fee schedule. On the other hand, PPO’s are an entirely different animal. PPO plans, while providing a very valuable service, don’t make it simple. Let me explain and give you a picture of what it is like. Imagine if you were the manager of a Target ®, and in that Target you had 600 items you sold (that is the approximate number of different services dentists can charge for). Every customer that came into your store on any given day had a different price they were supposed to pay for each of the 600 different items. For many of those customers, you, nor the customer, knew the exact price they were supposed to pay. When it came time to figure out the price, the company who contracted for the reduced prices wouldn’t divulge the information, so you had to guess. And if that wasn’t already tough enough, there is one more twist.

Each of these customers had an uncle out in the parking lot that was going to pick up a portion of the elusive price, and it was your job as the manager to know exactly what portion the uncle was paying. Furthermore, you were supposed to know exactly where that uncle lived and bill the uncle for the share he was going to pay; all because he forgot his credit card that day. To top it all off, the customer expected you to get it exactly right every time, or they got upset. Can you imagine? Yet this is the daily (or shall I say, hourly) life of a BC and Manager in the dental field.

Nevertheless, dental plans provide many patients. People are 2.5 times more likely to visit a dentist if they have a dental plan and in my estimation, that will only increase. It’s imperative that we work together to help patients understand the reality of dental plans – that they are a subsidy to help them reduce their dental expenses, not a “catch all” for everything they need. We need to have the patient’s trust that we are going to help them fully utilize thir valuable benefits. Patients must know that we are the dental insurance experts. They all want to use their benefits, and we are the best in the business at helping them maximize their usage.

  • Great educational explanation. I’m sure you’ll all do well on the PPO’s. It just takes a trusting backtrack to account for all the payment adjustments.

    God bless,

  • Hi Bebe,

    So nice to see that you found our blog. We need people like you on the carrier side to ensure our message isn’t one sided. Hope to see you at NADP.

    – Gary

  • Bebe Shuler-Mure

    Steve,

    Nice post — I like it. I am a big fan of discount plans as well and appreciate the simplicity! Also like the site overall. Good job. Say hi to Gary for me?

    Bebe