In a recent survey of 128 dentists and orthodontists, 98% think fee capping by dental insurance companies for services they do not cover is an inappropriate business practice. The survey, conducted by The Wealthy Dentist, a practice-management and marketing blog, also found that only 2% of respondents think such fee capping is a legitimate business move.
"They are only feathering their own nests by being able to offer a lower fee for non-covered services for which they do not collect a premium, thereby making the insurance plan more attractive to purchasers. A participating DDS is then obligated to charge a lower fee, thereby enhancing the insurer’s chance of selling their plan," said one orthodontist who participated in the survey. "If that is the case then a DDS should get a portion of the premium collected for unwittingly helping the insurance company."
According to the Academy of General Dentistry, 28 states currently have introduced legislation to stop insurance carriers from requiring dentists to accept caps on fees for services the carrier does not cover.
