Implementing a Membership Plan

Many of us could probably write books about the countless frustrations of dealing with dental insurance companies, especially the ones we are contracted with. The rigorous amount of time invested takes away time from completing other tasks.

This was the driving force that led me to research other options for patients and less work for my team. I attended AADOM in 2022 with a vision and a goal to find a membership plan that would work for my office. I attended several classes and spoke with numerous vendors that gave me the information and tools I needed to take back with me.

I am writing this article to share my journey with you and offer guidance to implementing a membership plan.

Preparation

Before presenting an idea for a solution, it is important to have research results and facts ready. The first step is to schedule demos with at least three vendors to use for comparison. Make a list of questions to ask and be direct about what you are looking for in a plan. Document the pros and cons of each and have a discussion with your leadership team after the demos. Once a plan is decided on, negotiate with the vendor until you are satisfied and have a mutual agreement.

The next step is to design the plan. An account specialist will be assigned to guide you through the decision-making process. Evaluating your practice for the demographics and diversity of your patients can help with the final decision. Adult, Child, and Perio plans are good choices to start with.

Next, the cost for each plan needs to be determined to make them desirable and affordable for patients. The account specialist can offer suggestions for fees, but it is advisable to evaluate your own numbers for comparison. To do this, gather data and compile an Excel spreadsheet. List the practice master fees for services that would be included in the plans (prophy’s, exams, fluorides, routine x-rays, etc.). Then, add your current contracted rates for those services and calculate the totals to show what the net production would be for each. Add the recommended membership plan rates for comparison.

It is wise to set the fees no lower than your lowest contracted insurance rates.

Once a decision has been made on the cost of the plans, the next step is to determine a percentage discount that would be appropriate to use for services. Decide if it will be a sole percentage or various percentages based on the types of services you offer. Prepare a comparison of fees, to help determine where the price margins should be in correlation with your fees and contracted rates. To do this, add the most common procedures (crowns, fillings, implants, etc.) to your spreadsheet and fill in the UCR’s. Play with the numbers by adding various percentages, until you are satisfied with them.

Keep in mind, there will be no insurance claims involved in the end, which will decrease work, time, and frustration for your team.

Marketing

Decide how you want to market your membership plan. Set a goal for when the plan will begin and prepare your marketing supplies accordingly. Your vendor may provide brochures, or you can design and make your own. Add your plan to your website, share the information on social media, and place signs and brochures in your office. You can have postcards made and mailed to your patients who don’t have insurance or have insurances that have minimal benefits. Consider creating small business cards that can be easily handed out by your team.

Ultimately, there are many ways to market, and you just need to find the ones that work for you.

Training

While waiting on your marketing materials, take the time to train your team so they are comfortable presenting and discussing the plan. Schedule a team meeting to introduce the membership plan as it is imperative for all team members to understand and use the same verbiage. Training videos can be a great resource as well as role-playing to build confidence with presentation.

Dentists, hygienists, assistants, and the business team should all have this training and be onboard and ready to go.

Set-up in Practice Management Software

There will be a membership portal for patients to sign up through, and the office will have full access which keeps it separate and easier to manage. However, a decision has to be made on how the plan will be entered into the PMS.

There are multiple ways those plans could be set up. Here is one example that can be used for Eaglesoft:

• Create an insurance category that can be attached to an employer. Make a fee schedule or coverage book if desired.
• Make 12 employers, one for each month (Membership plan 1 – January, Membership plan 2- February, etc.), and attach the insurance to each one. Whichever month a patient enrolls, that would be the employer to select. Using this method will assist with simplifying reports and tracking plans.
• Create a pop-up account alert that can be attached to each patient as they are entered in the system. Having an icon on the alert will provide a quick visual to the team.
• If there are multiple providers in the practice, consider creating a separate membership plan provider to use when charging out the plan. Doing this will not impact the provider’s production.
• Finally, create a membership payment type and a membership adjustment type. These are used for debit and credit payments and services in accounts. Depending on the vendor you decide on, there may be integration with your PMS, and the payments will be automatically credited and debited in the patient accounts.

How It Has Been Successful For My Practice

Our membership plan launched in the middle of December, and we had our first 10 members before the end of the month. By the end of January, we were at 30 members. It has been successfully growing, and the patient response has been incredible. The team has become comfortable presenting to patients and answering their questions.

My ultimate goal for having this plan is to offer patients an alternative to their current insurance plans, and an option for patients without insurance. This is the first step towards my vision of a fee-for-service practice. My next task is to create and implement an employer-based membership plan to be offered to the small businesses in our area.

Many of you may have a membership plan that is working well for you. If you don’t and are considering offering one, I would recommend it and would be happy to answer any questions you may have. I can be reached at trina@paxdental.com.

About the Author

Trina Shipley, FAADOM has worked in dentistry for over 26 years. She was a CDA for several years before moving to the business side and management. She is currently the accounting manager for Pax Dental, in Southern Maryland. Trina is a lifetime AADOM member and earned her AADOM Fellowship designation, (FAADOM) in 2016. She is currently working on her Mastership designation, (MAADOM) with hopes to be inducted this September. In her free time, she enjoys traveling, motorcycle rides, and spending time with her family.