Contract Clause Conflicts: What to Do?

As noted in our last blog about contract conflicts, many aspects of dental insurance contracts heavily benefit the insurance carrier at the expense of the doctor. If an insurance carrier’s low reimbursement rates fail to cover the cost of operation, dentists can reasonably refuse to contract with that specific carrier. The ADA provides information on understanding and weighing the value of insurance contracts in a guide called What Every Dentist Should Know Before Signing a Dental Provider Contract.

Unfortunately, opting out of major insurance networks can affect patients’ access to care, and potentially reduce a dentist’s overall patient load. On the other hand, when dentists decline exploitive insurance contracts, it puts pressure on insurance companies to provide mutually beneficial contracts. Carriers cannot sustain unprofitable contracts if no dentists accept them. That’s why dental practices must carefully consider the terms of each contract before agreeing to them.

Where We Come In
​We can make addressing insurance policies and profitability simple by:

• Requesting a copy of each of your signed contracts.
• Deciphering the contract requirements and troubleshooting any coding questions that come up among your staff.
• Adjust billing procedures as needed to adhere to your insurance agreements.
• Retrain staff to ensure understanding and adherence to dental insurance policies.
• Regularly renegotiating insurance fees, in addition to handling re-credentialing and contract aging

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With this service in place, our clients naturally comply with their contracts, avoiding fraud through ignorance or intention. Additionally, we help our clients understand their contracts and weigh the benefits and drawbacks associated with each plan, so they can make informed decisions about which plans to accept.

By teaming up with us, our clients gain insight into the complicated and ever-changing world of dental billing, take the burden of dental billing off of the staff’s shoulders, and confidently comply with dental billing contract law. Give us a call to learn more about navigating insurance contracts.