Question Number Eight: Access To The Masters Founder Frank Wolf, DDS asks ADM President Daniel A. ‘Danny’ Bobrow, MBA How can I attract more fee for service patients?

Dr. Frank Wolf: All right. Let’s move on to question number eight. How can I attract more fee for service patients?

Daniel Bobrow: This is kind of the same question as the one about wanting to only accept patients ready to accept comprehensive dentistry, isn’t it? I think the choice of whether and with which Plans to participate, of course, depends on a number of factors. There are ways to identify and specifically target segments of your service area that may be more or less likely to be uninsured, and be willing to pay out of pocket.  Of course, we also know that dental insurance, even for those who have it, is anything but a panacea. Your objective is first to connect with, and then communicate the Value of your Offering to everyone in your service area. If you don’t accept their insurance, you have an opportunity to educate them as to the reason.

In any case, even if the timing is not right for them, their friends, co-workers, or family members may be the type of patient who value your Offering today, which is why your goal ought to be to sell, that is, convey the value of your practice, to  all with whom you have the privilege and opportunity to share it.

There are some very good resources available that can help you attain the verbal skills necessary to help patients understand just how inadequate dental plans are and how they actually prevent people from receiving the level of care they deserve.  It’s important not to become unwitting accomplices to the insurance companies who even have us using terms like ‘usual and customary’ when we’re talking to patients. “Our fees are higher than the usual and customary.” What does that imply? It’s like we’re saying, “We overcharge.” We’ve got to be careful with the words we choose.

Dr. Frank Wolf: Tell us a little bit more about the message and the influence that insurance companies have with the language or vocabulary that the mass consumer is using. You used ‘usual and customary’.

Daniel Bobrow: Yes. That’s the most blatant example. Remember, insurance companies are marketing all the time to your patients, or the public. For them, the goal is cost containment. I’m sure you’ve heard it’s not managed care, it’s managed cost. The insurance companies, the employer groups that offer the policies to their employees, are all concerned about one thing, and that’s minimizing costs.  Unless they’re really enlightened, and they have the long-term health care of their employees at heart. They’re implying that because of a $1,000 or $2,000 a year benefit, that’s somehow adequate: again, the implication being that dental care should not cost more than the insurers are willing to reimburse.  They haven’t even kept up with the cost of living.

Dr. Frank Wolf: In the late 1960s annual benefits were $1,000.

Daniel Bobrow: Yes. It’s absurd. We need to just take the fight back to the insurance company or at least take back control over the communication. But there are some insurance plans that might be profitable for certain practices. It’s beyond the scope of this discussion, but knowledge is power and there are a couple of very fine organizations out there that will help you to determine exactly what your profitability of your practice is, of various procedures. Then you can look at an insurance plan and say, “Well, this fee schedule is just not profitable for me. I would be buying the business if I treated these patients.”

Dr. Frank Wolf: Right. And I think a lot of practitioners want to participate, or want to expose themselves to as many new patients as possible, so they enroll in reduced fee plans, and managed care plans, and really that just comes down to a matter of choice. In all the years that I practiced I was fee for service. And believe me, there were times when I was starting out early in my career, and cash flow was tight, and I was being solicited by managed care companies and reduced fee plans, and there’s large employers in my community and they were promising me all these new patients, and I had to make a choice.  I held fast to not participating because I wanted to create and build an insurance-independent practice. I’ll tell you, it is so much more enjoyable when you treat patients that aren’t coming to you because of an insurance plan that you accept or work with. I just really want to say that if doctors want more fee for service patients, they have to make a commitment. They can’t have one foot in the reduced fee plan, managed care pool, and another foot in the Ritz Carlton pool. You’ve got to make a choice. It’s going to be one or the other. I’ve seen practices transform from reduced fee plans and managed care. They made a commitment – and it took them a little while to make the transition. They had fewer patients, but of the patients that stayed with the practice, they were much more profitable, worked a lot less, and they were a lot happier.

Daniel Bobrow: Right. It’s a matter of working smarter and not harder. It’s also consistent with another tenet of marketing: you can’t be all things to all people. You need to define yourself and your mission and your position, and then stay true to it.

Dr. Frank Wolf: Absolutely.

by Danny Bobrow


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