AADOM QUICKcast: How to Translate Insurance Concepts into Results
Video Description:
We are home from AADOM ‘23 and ready to unpack this year’s sold-out conference! Join key opinion leaders Teresa Duncan, MS, FAADOM, Debbie Jones, RN, MN, DAADOM, and Vanessa Escobar, MAADOM as they discuss their experiences and best practices for implementing insurance assessment strategies into your practice.
Course Learning Objectives:
- Breaking down the year in dental insurance
- Exploring current trends in third-party payer relationships
- Identifying the processes to implement first to have the greatest impact
- Exclusive resources to support you along the way
Sponsored by: Kleer
Your Roadmap to Begin Reducing PPO Dependence
In dentistry, where every step counts, finding your route to a life less tethered to Preferred Provider Organizations (PPOs) can feel daunting. PPOs have historically held sway, shaping how your patients access care and your practice’s ability to be profitable. However, the journey towards reduced PPO dependence is well within reach.
For Debbie Jones, RN, MN, DAADOM, moving out of network was a strategic initiative designed to attract a high-quality associate to carry on her husband’s legacy.
For Vanessa Escobar, MAADOM, years of being in network with over 24 PPO providers and dealing with 50-60% of UCR going towards insurance adjustments made her think there had to be a better way.
Both of these distinguished Office Managers recognized from the outset that, before making significant changes, they needed to establish a solution that wouldn’t disrupt patient care or office productivity. This solution also had to be user-friendly, secure, and compliant for their teams.
After thorough deliberation, Debbie and Vanessa turned to Kleer to implement a dental membership plan. This plan was an alternative to the PPOs their offices no longer accepted and was a valuable addition for patients and their families.
“We wanted to implement a membership plan so that we could provide our patients with another alternative to their dental care so that they could receive regular preventative care at a reduced rate, with reduced fees, along with member benefits for restorative care, with none of the challenges associated with dental benefits companies such as deductibles, maximums, waiting periods, and all of the things that we deal with daily when working with dental insurance.” — Debbie Jones, Michael Jones DDS.
“In 2018, our office was in network with 24 PPOs. After attending a conference and educating myself, I realized that most did more harm than good for our office. When we began the process of eliminating bad PPOs, my team started asking, ‘What about our patients who want to keep seeing us?’ That is why we started looking into membership plans. I knew I wanted something easy for my team to implement that could automate payments and would not require much extra work.” — Vanessa Escobar, Winter Garden Smiles.
To learn more about their story, Teresa Duncan, MS, FAADOM, moderates the discussion, shedding light on their journey. She also breaks down the year in dental insurance and explores current trends in third-party payer relationships.
Need more time to watch? Here are our four key takeaways.
Build Strong Relationships with Patients
Reducing PPO dependence doesn’t mean abandoning your loyal patients. Maintaining strong relationships with them and proactively communicating the changes is crucial. This is an opportunity to educate your patients about the benefits of your membership plan and other services you offer. Open and transparent communication can help build trust and keep your patients engaged.
Evaluate and Adjust Your Financial Mode
Moving away from PPOs necessitates a reevaluation of your practice’s financial model. You’ll need to determine how your practice will offset the revenue that PPOs previously brought in. This includes setting fees that accurately reflect the value of your services and often involves careful market research and benchmarking.
Customize Your Dental Membership Plan
A dental membership plan is a cornerstone in reducing PPO dependence, but it’s essential to
tailor it to your practice and your patient’s needs. Debbie and Vanessa both understood that a one-size-fits-all approach wouldn’t work. They crafted membership plans that provided value to their patients, offering regular preventative care and unique treatment benefits for restorative care. When developing your plan, consider the demographics and preferences of your patient base.
Stay Committed to Continuous Improvement
The process of reducing PPO dependence does not occur overnight. Gather feedback from your team and patients to identify areas for improvement. Stay updated on trends, best practices, and changes within the industry that may impact your approach. Be willing to refine your strategies over time to ensure long-term success.
Final Thoughts
Moving away from PPO dependence in dentistry is a strategic and achievable goal, as demonstrated by the experiences of Debbie Jones and Vanessa Escobar. And as Teresa Duncan explains, “Mindset is everything.” You can create a more independent and sustainable dental practice by educating and empowering your dental team, proactively communicating with patients, and addressing the additional aspects mentioned above. It’s a journey that requires effort and dedication, but the rewards in terms of practice autonomy and patient satisfaction can be well worth it.
About Kleer
Kleer is the Official Dental Membership Plan Platform of AADOM. Our advanced software, intelligent integration solution, dedication to your growth, and unmatched support are foundational to our best-in-class solution. From building and pricing your plan to onboarding, marketing, support, and beyond, we have the expertise and insight that comes from working with thousands of dental practices nationwide.
To learn more about Kleer, request a time to talk here.
Teresa Duncan, MS, FAADOM is the author of “Moving Your Patients to Yes: Easy Insurance Conversations” as well as a contributing author to the ADA’s annual CDT Companion Guide™. Her podcasts “Nobody Told Me That!” and “Chew On This!” provide regular coding and management updates. Teresa was recently presented with AADOM’s Lifetime Achievement Award.
Debbie Jones, RN, MN, DAADOM, is the Practice Administrator for her husband Mike Jones’ General Dental Practice in Newport Beach, CA. Debbie has been an AADOM member since 2018, and in 2021 she earned her Fellowship (FAADOM) designation, in 2022 completed her Mastership (MAADOM) designation, and in 2023 received her Diplomate designation. Debbie loves learning and has attended every AADOM conference since she first joined the association in 2018.
Vanessa Escobar, grew up in Central Florida and attended Florida State University, earning a BS in International Affairs with a Minor in Business Administration. She joined Winter Garden Smiles in 2011 and oversaw the finances, operations, and marketing. Vanessa is the Founding President of the Central Florida Chapter of AADOM. She received her FAADOM in 2021 and received her Masters (MAADOM) this September. During her time off, she enjoys spending time with her husband, Ricardo, and her kids.
