![]() Good practice is to review your contracted fee schedules annually. Check the next Explanation of Benefits statements to ensure that the fee changes are appropriately reflected.After you succeed, make sure you have copies of all signed documents.Request information on whether the carrier leases their network and whether the revised fees will apply to any networks you have been leased into.Be patient and don’t give up! The first offer you receive may not be the best offer.Let the provider relations representative know that you value the patients garnered from being a network dentist. If comfortable, request a phone call or continue making your case in writing. This may be someone known to your business staff, typically with the title of “provider relations manager.” Identify the payer’s provider representative assigned to your region who you can contact to begin to make your case.Use all of the above the information you have gathered to tell your story.REVIEW THE ADA’S 2022 SURVEY OF DENTAL FEES EFT enabled for receipt of claim payments.Use of online portals to verify eligibility and benefits.Patient satisfaction rates (most recent available)ĮFFICIENCIES YOU OFFER: WHICH OF YOUR BUSINESS PRACTICES ARE FAVORABLE TO THE PAYER?.Costs associated with operating your business.Extent of preventive services that your office provides.Extent of these procedure codes’ contribution to your overall practice revenue.Current allowed amount (i.e., your current discounted fee).Frequency with which each procedure is reported.Know which procedure codes generate the highest total revenue for your practice, including: YOUR NUMBERS: WHAT DATA DO YOU NEED TO NEGOTIATE EFFECTIVELY? Influx of new patients covered under the plan.Wait times for available appointments, impacting the patients covered under the plan.YOUR STRENGTHS: DO YOU HAVE ADVANTAGES IN TERMS OF ACCESS? ![]() Before you enter negotiations with a payer, prepare your talking points and do your homework. This negotiation should be done individually, between only you and your plan, and not with or on behalf of other dentists. If you are a participating provider with one or more dental benefit plans, you may need to negotiate your fee increases. The ADA anticipates that the cost of care will substantially increase for dental procedures. Under these circumstances, dental offices may see the need to readjust their fee schedules. To limit transmission, the American Dental Association (ADA) has issued interim recommendations aligning with those from the Centers for Disease Control for infection control and the use of personal protective equipment. Dentistry faces increasing standards for infection control following the COVID-19 pandemic.
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