When is it time to hire a professional to negotiate on your behalf? Our company prides itself on being very up front about who is a good fit for our services and if we think we can’t deliver what you need we’ll tell you up front!
1. Whether you negotiate on your own or hire a professional, have realistic expectations. Be very cautious of companies promising huge increases that are simply not realistic. The reality is that there are some insurance companies that do not negotiate, others that do, and the key is to maximize results by knowing how each company works. There are no short cuts and not only do you want your office to obtain good results now, you also want your rep to remember your office in a positive light for the next round of negotiations.
2. Remember that whoever negotiates on your behalf is a representative of your office. Whether it’s the doctor, a staff memeber or a professional, your results depend in part on who represents you and how well they understand each company’s systems. Excellent negotiations do not come from strong-arming or rude communications. They come from a clear understanding of the parameters that each insurance company works with and then packaging the negotiations in a way that maximizes each insurance company’s system to the dentist’s benefit. Insurance company negotiators are in a separate division from claims and usually do not even have access to claims information. Frustration from payment issues or other insurance related issues need to be kept separate from the negotiations conversation.
3. Reputation in the industry is key! If a dentist’s office calls to negotiate on their own they will call the main 1-800 number and hope to get re-routed to the right rep whereas we are constantly working with the same reps over and over and can reach them directly. We began this company knowing we were setting our reputation with each and every phone call we made to every rep. We work with the same reps and the same companies with clients across the country and our goal has always been to make our reputation golden in the insurance industry. Receiving top dollar for our clients is our number one priority and we get ongoing quality results because the reps we work with know that we understand the industry and how to package negotiations in a way to benefit our clients while also creating a quality reputation on the other side of the table. Insurance company negotiations are comprised of a relatively small network of professionals who handle negotiations. Our results are strong because our clients get the advantage of the reputation we’ve created.
4. One of the trickier parts of negotiations is understanding how to compare final offers. In some cases a direct contract may be better, in other cases a third party administrator may pick up a company at a higher rate. There can be various ways to contract to get paid differently on the same patients so negotiations no longer just mean a single perspective. Offices who want to position themselves the best need to understand how to compare negotiations so that different offers for the same patients can be analyzed accordingly. This information is changing rapidly as insurance companies continue to make new agreements with fee schedule leasing and third party adminsitrators so someone who has their thumb on the pulse of the industry is important when offering guidance.
5. Most companies that do negotiate only allow negotiations once every 18-24 months. If your initial contracts were signed less than 18 months ago you are better off waiting until we can reach out to all companies at the same time to get you better results. Some companies don’t negotiate at all. We’re happy to give you preliminary feedback about this if you contact us. If the majority of your production is non-negotiable we’ll tell you. If we don’t think we can deliver a good ROI for you, you’ll know it ahead of time!
6. Remember that in the same way an office can get put on a “red flag” list for improper billing, an office can also get put on a red flag list during their negotiations, depending on how your office is represented. The dental industry is changing quickly and creating a situation where an office is viewed unfavorably from negotiations tactics never works to the dentist’s advantage. Our company is proof that hard negotiations can deliver top results when using our quality reputation for the benefit of our clients. Our biggest compliment is the number of our clients who continue to come back for renegotiations! We’re happy to send you an extensive list of satisfied clients that you can personally reach out to for added feedback.
Some carriers may even add additional layers for companies which have either not earned, have lost due to inappropriate behavior, or have not yet established a reputation which includes a strong level of confidence that fee schedules and internal carrier data will not be shared in violation of the doctor/carrier contract relationship. Over the years we have worked quite hard to earn the reputation that we have with the carriers and their individual representatives, allowing us to communicate on behalf of the individual dentist while allowing the carrier to work with us with the necessary confidence that we will maintain their confidentiality and will never misuse information obtained or share it with anyone not specifically authorized to share that information by the carrier. Our doctor contracts specifically address both the doctor’s responsibility as well as our requirement that any information that we obtain from a carrier will only be used for the doctor it was specifically provided for. Should someone offer to share a fee schedule with you that was not originally offered for your individual practice, they are violating their contract and we strongly recommend resisting the urge to view it. We also will not accept fee schedules to view that are not actual current fee schedules for our contracted dentist or fee schedules offered to that dentist at the same location. We will never share a fee schedule that was provided for a specific doctor we are contracted to another doctor and we do require our dentists to sign an agreement honoring the same. Carriers are rightfully tightening up their parameters in response to some new and highly controversial approaches in the consulting field, but we continue to maintain the reputation we’ve worked very hard to build, not just because it’s the path we feel is ethical and sound business practice but also because as a dentist representative, we are representing our dentists and how we represent them may influence their position with a carrier over the long term. Doing it right is not just our company commitment to ourselves, but it is also our company commitment to our doctors and to the carriers we work with.
Our negotiations are overseen by one of our owners, Lisa Weber. You will be hard pressed to find anyone in the dental insurance industry who has dedicated more time to developing dental negotiations on behalf of dentists. For more information about whether or not our services may be a good fit for you, fill out our contact us form and we’ll email you some information to review.