An innovative option that frees your patients from the hassles of dental insurance
Jessica Raymond-Allbritten, BASDH, CRDH
As dental hygienists, we all hate to see patients leave our office because they are losing their dental insurance or our office no longer accepts their insurance plan. But what if there were a way to keep those patients from having to leave the practice?
An in-office dental membership plan may be the answer to help patients avoid having to leave for another practice that accepts their insurance or having to go for years without proper dental care due to a lack of insurance coverage. In fact, having the option of an in-office dental membership plan may be a huge component of dental care in the future.
The basics of in-office membership plans
Membership plans are designed to be offered to patients who lack insurance coverage. Patients can pay a monthly or annual fee directly to the practice for preventive care and discounts off of restorative treatment, dental merchandise, and whitening treatment. Because the plan is offered directly through the practice, it isn’t necessary to submit any insurance claims or preauthorizations. There are third-party companies, such as BoomCloud and DentalHQ, that can be used to help track membership patients; however, an office may choose to use an in-office spreadsheet to keep track of used membership benefits and renewal dates.
The beauty of helping your office develop an in-office membership plan is that you can design the program to fit your practice and patients’ needs. Offering two different tier membership plans is an option as well. For example, offering one membership that has two prophylaxis appointments and one that has four periodontal maintenance appointments allows you to cater to two different kinds of patients.
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How having an in-office membership plan works in my office
In the office where I work, our in-office membership plan is available for $289; additional household members can be added to the plan for $259 each. The membership includes two periodic or limited exams, two prophylaxis or periodontal maintenance appointments, one oral cancer screening, two fluoride treatments, all necessary radiographs, 20% off restorative treatment (when third-party financing isn’t used), and discounts off whitening, salivary diagnostics, and oral care products. The membership plan is good for 12 months. We use Excel to track remaining benefits and renewal dates.
Offering membership plans to patients has garnered a variety of benefits for my office. Having this membership plan has allowed us to keep patients as we drop low-reimbursing insurance plans. It also helped generate predictable, recurring revenue while keeping the hygiene schedule full. Patients come in because they want to get their “free cleaning” that is included with the membership. It is the same “free cleaning” that they would get with their dental insurance. Their thinking is that they want to use the benefits that they paid for. During this visit, the hygienist has the opportunity to discuss the pending restorative treatment plan, which in turn generates a full schedule for the doctor. This restorative work may have been lost to another office or the problem may have worsened, resulting in a decline in the patient’s oral-systemic health if the patient did not have the in-office membership plan.
Benefits of an in-office membership plan
Having an in-office membership plan can help gain new patients, strengthen loyalty, increase treatment acceptance, and help remove any barriers to accessing dental care. Membership plans are easy for patients to understand, so the question, “Does my insurance pay for that?” goes out the window. In-office membership plans are transparent and leave patients with black-and-white information regarding coverage. Treatment acceptance for fee-for-service patients also increases due to the treatment discount that can be offered. People like discounts and are often encouraged by them in addition to the fact that they value their dental treatment. When presenting a treatment plan, it can be helpful to show patients the full fee for the procedure in one column and the discounted fee in a second column. Showing patients their savings helps create trust and loyalty and encourages them to feel like their investment in their health with your practice is their best option.
According to the Centers for Disease Control and Prevention, more than one-third of Americans haven’t seen a dentist in at least a year. The American Dental Association discovered that of those people, 40% stated they didn’t see a dentist in the past year because of cost.1 Implementing an in-office membership plan can help make dental care more affordable and remove the financial barrier for some patients. People who do not have dental benefits are more likely to suffer from other nondental-related diseases, such as heart disease and diabetes.1 By offering a membership program and advertising the program, the practice has an opportunity to gain new patients and improve access to care, thus helping Americans become healthier.
Is it legal to offer in-office membership plans?
Some states do have laws regarding in-office membership plans. According to the National Conference of State Legislatures, 24 states have discount health program laws, with some of those states requiring a license for discount in-office membership programs.2 It is important to check your state statutes before developing an in-office membership plan. A table of state statutes can be found on the National Conference of State Legislatures website.2
Creating an in-house dental membership plan can help create a fee-for-service practice, develop loyal patients, increase treatment acceptance, and remove patient barriers. Implementing an in-office plan that fits your practice can take time, but in the long run it will help grow your patient base and help your patients become healthier.
1. The surprising truth about dental insurance. Colonial Life & Accident Insurance Company website. https://www.coloniallife.com/employer-resource-center/2018/april/the-surprising-
truth-about-dental-insurance. Published April 11, 2018. Accessed April 18, 2018.
2. Cauchi R. Health care discount plans: State roles and regulation. National Conference of State Legislatures website. http://www.ncsl.org/research/health/health-care-discount-plans-state-roles.aspx. Published January 31, 2007. Updated January 2012.
Jessica Raymond-Allbritten, BASDH, CRDH, practices dental hygiene with Ryan Lepore, DMD, at Lepore Comprehensive Dentistry in Dunedin, Florida. Jessica was a member of the 2015 Colgate Oral Health Advisory Board. She is also a contributing author for the Colgate Oral Health Advisor web page. You may contact her at [email protected].