The internet is amazing. I have access to perspectives about my dental practice and how it affects people I probably know, but never get the chance to discuss it face-to-face. I came across this comment today. It was posted in 2009.
"We began using Dr Rafoth over two years ago and at the time asked if they are providers for our insurance, Washington Dental. We were told they are providers and bill our insurance. Over the years we always asked and wondered why it seemed we were paying so much and the standard response from the staff at Cascadia was "that's just what your insurance paid and the rest is your balance". I finally called around and found that the prices at Cascadia were way higher than other offices. When I called to discuss this Cascadia staff finally disclosed they are not 'preferred' providers for Washington Dental, they are only 'contract' providers and that it is up to the patient to know this. I was infuriated as with a family of five we have spent thousands with his office, and could have saved 40% or more by using a real provider accepted by our insurance company. Later the same day I spoke with a parent at one of our local schools who stated Dr Rafoths Cascadia Dentistry had done the exact same thing to her family, costing her hundreds of dollars before she figured it out. Be careful folks. They will tell you they bill your insurance and are providers without disclosing they are not 'preferred' providers. Know also that my husband had a cap come loose almost immediately after Dr Rafoth did the procedure and we had to pay for him to fix it."
As the dentist and owner of Cascadia Dentistry, I have to say I'm glad this comment was posted. is a valid and not uncommon complaint that gets to the heart of the dental insurance issue that all patients face. In addition, it is a challenge to support a family with affordable dental care.
The continued rise in healthcare costs and stubborn restrictions of insurance policymakers make it tough for both patients and doctors to succeed in a healthcare relationship. Does a family forgo great dental care from a doctor they appreciate for their family because of the rising costs? That's a tough one to answer, because dental insurance plans have historically been poor at offering a relatively similar level reimbursement as the medical industry. Another important question to consider: Does a doctor or dental practice decide to reduce their fees and their delivery of comfortable, effective, and long-lasting care? This is a tough one, too, because healthcare is expensive to deliver if it is to be done with high quality.
My feelings about this issue have vacillated since this comment was posted three years ago. I made a personal decision in the wake of the economic downturn of 2008-2010 to become a contracted, preferred provider for Washington Dental Service, the largest insurance provider in our community. Up until then, I had wanted to offer a high level of service and the best technology available to my patients without signing an insurance company contract that would limit payment for delivering the expensive services I provide. But the trend for patient expenses has not fallen at all in the past 13 years I have been in Stanwood. So I felt that I had to engage a plan that would reduce my fees for dentistry in a few ways, and allow a greater number of patients to have better access to the same high-quality dentistry I have always provided. Here we are in 2012, and there is yet another project I am undertaking to improve patient access to less expensive care in our office without compromising quality. I will keep the neighborhood posted as it is ready to roll.
I am glad that the person who posted this comment made the effort to research how their insurance plan reimbursement affects their family. I think that is an essential part of being a well-informed patient, and it strengthens the doctor-patient relationship. I encourage all patients to do the same.
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ReplyDeleteA footnote to this blog: Washington Dental Service is currently in its 6th month of fee reductions to contracted Washington dentists. This fee reduction has created an average practice revenue loss of 20%. Dentists that are seeing a majority of their patients under WDS contracts are now making drastic choices to limit care, retool their entire practice philosophy and model to volume-based dental care, or altogether end their careers because this is a severe cut in cash flow to maintain a dental practice.
ReplyDeleteIn the end, this is creating a real logjam for patient access to care. There are already too few dentists to support the growing patient pool.
Currently, there is no guarantee from WDS that they will stop fee reductions this year. I and the rest of the contracted doctors are preparing for another round of losses. I am uncertain as to what will happen with our practice in the wake of another cut. One thing is certain: I will never practive volume-based dentistry. High-quality, low-volume, patient-centered care is too important to me.
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