Insurance Agent Forum

[robliano]

Now you have me craving pizza!! And I just had sushi, wonderful!

Originally Posted by moonlightandmargaritas

My favorite little pizza joint here in Tampa is run by two brothers from NYC. Just a hole-in-the-wall, with the excellent (authentic) thin crust NY pie - the kind where you have to fold over a slice to eat it. I always order a Peroni with it. They each work about 156 hours a week.

Place hasn't been remodeled since 1968. Their prized possession is a picture of them with Vinny Testaverde when he was with the Bucs.

Approved payment modes: NO credit cards, NO debit cards, NO checks.

Cash.

[TXINSURANCE]

So we pay just over $150 per year for a family plan and save $1,200? Not bad actually.

I have customers that would call and complain about that "small" savings.

[GreenSky]

Originally Posted by healthagent

All true - but for me it's a no-brainer since it's our dentist who's recommending it.

For all discount plans - forget about the network search. Call you dentist and see who they take.

John, since the dentist is not receiving payment from the discount plan, why the hell doesn't he just offer you the discount without you paying the $150?

Why would he "force" you to buy into a discount plan when all he's doing is offering a discount to you?

You want Chumps to call and negotiate a better price for you?

Rick

[motoxxx]

Most individual dental plans (discount or insurance) aren't worth the money. For the discount plans I always tell my clients that if they need major dental work done right away that a discount plan is a great way to save money so long as they don't really care who does the work. Most of the dentists that accept these plans are either new practices, or from a foreign country etc. For these types of clients, these discount plans can be worth the money. Some of them will bundle other benefits with them such as chiropractic, vision, or RX discounts.

The dentists that have thriving practices don't join discount networks because they don't need to. I asked my brother in law (who makes about $1 million with his dental practice) which dental insurance plans he prefers and he told me NONE! He hates having to wait to be paid. He will many times give someone a 15% price break if they come in and just pay cash.

[Ray Ray]

Originally Posted by healthagent

I'm not a fan of dental discounts plans - haven't seen the value yet. Well, my wife comes home today from the dentist - needs a root canal and crown - total, just over $2,400.

This is actually the owner - dentist who handed the pamphlet to my wife, then worked her up the cost if we signed up - less than half - under $1,200 for everything.

So we pay just over $150 per year for a family plan and save $1,200? Not bad actually.

The Dentist is the Owner of the Dental Discount Plan?

The Dentist used the Discount Dental Plan membership to cut his/her cost of the treatment by 50%. Great way of cutting their fees, yet still maintain their professionalism, and get you to agree to the treatment plan. You most likely would have felt differently about the Dentist if they quoted you $2,400 and then said they would just give you a "good guy" price of $1,200.

[HealthGuy]

Moonlight: What exactly was the issue with the DP Dental Discount plan you sold that was a hassle? Please more details...My view is if they spend $150 per year on one of the discount plans through DP Brokers and they save $600 on a crown or partial, then no harm - and the client comes out ahead...What was the exact issue your client had with the dental discount program and which one (there are like 100 with DP Brokers) gave them the toothache?

[moonlightandmargaritas]

Originally Posted by HealthGuy

Moonlight: What exactly was the issue with the DP Dental Discount plan you sold that was a hassle?

As I recall, the lady needed a crown. She went to a par provider in the Aetna discount plan.

Dentist wouldn't accept the negotiated rate as payment. Claimed "confusion" as to which plan she was on. Took my client to collections, whole nine yards.

No help from either Aetna or dp - nowhere to be found. While the prime fault probably lies with the dentist, who needs the client hassle for $1.42 a month?

[healthagent]

The way to protect yourself is simple - go to your dentist or a local dentist and simply ask which plans they take including any discount plans.

Discuss the fees before the procedure to clear any possible confusion. Our dentist prints out a statement of charges for us to review before any procedure.

[somarco]

if they spend $150 per year on one of the discount plans through DP Brokers and they save $600 on a crown or partial, then no harm - and the client comes out ahead..

Maybe they do, maybe they don't.

The problems with discount plans are considerable, not the least of which is a lack of accountability.

How do you know that $1100 crown (what my dentist charges) will really cost you only $600? Maybe the $600 is just his fee but lab fees are another $150 - $200. He may charge extra for an unnecessary cleaning or debridement before starting the work or may try to talk you into periodontal work that is not necessary.

Of course these are just the dollar issues. As has been pointed out, typically these are inexperienced dentists that join networks. My dentist does take assignment from most carriers but is not in network. He charges full price and clients who have coverage pay the difference in what their plan allows and his price.

I have 5 crowns and no problems. My wife has one and it has been a problem as long as she has had the crown. She used a different dentist and has never been satisfied with the work. Not all dentists, even those who have been in practice for a while, have equal skills.

As Paul indicated, if there is a dispute you do not have an advocate. While the dentist may be in the Aetna network for insured patients that does not mean they are in the Aetna discount network. Carriers often have more than one dental network with different price structures.

The problem with dental networks is like the stand alone medical discount cards. If the provider refuses to honor the discount you don't have an advocate.

The result is a client issue.

I offer DP along with the Humana (Comp Benefits) and now the Time DHMO plans. I don't promote them, but do make them available if anyone asks.

If you want client complaints, the best way to do that is to push a dental plan.

[healthagent]

In our case it's laid out and in writing - we're saving $1,200 next week with my wife's procedure. The key is getting it in writing.

[ABC]

Originally Posted by moonlightandmargaritas

As I recall, the lady needed a crown. She went to a par provider in the Aetna discount plan.

Dentist wouldn't accept the negotiated rate as payment. Claimed "confusion" as to which plan she was on. Took my client to collections, whole nine yards.

No help from either Aetna or dp - nowhere to be found. While the prime fault probably lies with the dentist, who needs the client hassle for $1.42 a month?

I agree with that 100%
The time I spend working dental claims is no where worth the money I make on them. I would 80% of the time its the dentist fault because they do not read the contracts they sign.

[Insuranceman]

I just got a quote from my dentist for a root canal and a crown for $ 1,200 no discount included. I'm going in next week to have it done.