Underbelly-of-HMOs-and-PPOHi everyone!

One of the questions we sometimes hear at our dental office in Southfield is “Why don’t you take my dental insurance?”  The question is a valid one in these tough times, so let me explain our decision not to participate in dental health maintenance organization (HMOs) and dental preferred provider organizations (PPOs).

When one of these insurance companies partners with your workplace, it sounds good because on paper it looks as if there will be less out-of-pocket money for you, the employee. These HMOs and PPOs are doing this out of the goodness of their hearts, right? Not exactly!

You should know that dentists are not chosen to participate in HMO’s or PPO’s on the basis of their competence or skills.  It is a purely financial arrangement between provider dental offices and insurance companies structured so that dentists with openings in their schedule are able to procure more patients and insurance companies are able market a lower cost insurance product to employers.  To get new patients, the provider dentists agree to be reimbursed by the insurance companies at a drastic reduction – sometimes 30-50 percent less than the usual dental fees charged for particular procedures. While you as the patient may assume that you are receiving the same quality of care from the dentists who take HMO and PPO insurance cards, the actual dental care provided must be compromised in order for provider dental HMO and PPO offices to realistically stay in business.  An example would be hygiene visits of  ½  hour vs. 1 hour or “double booking” (scheduling 2 or more patients to be seen by the same provider at the same time).

This is not always the case, but many dentists under this kind of financial pressure look for ways to reduce their expenses. They have to balance their books, so some opt to:

  • Use less experienced staff with lower salaries
  • Shorten appointments and “double book” to squeeze in more patients
  • Use cheaper, less quality materials
  • Use cheaper, volume oriented or even off shore (example, China) dental laboratories
  • Use fewer disposables to cut sterilization costs
  • Forego purchase of newer technology and updating equipment

At our Southfield dental practice, we choose not to participate in HMO and PPO plans. While you may have some increased out-of-pocket expenses, it is our observation that the increase in patient co-pays involved in seeing a “non-participating” dentist only varies by 10-20%.   At our office you are guaranteed to benefit from premium quality materials and labs, the most up to date technology, and the best patient care and attention to detail possible.  Excellence is our goal.

To make an appointment with me, Dr. Mark W. Langberg, call us at 248-356-8790.

That’s all for today, until next time,

Dr. Mark W Langberg, DDS, MAGD
26206 West 12 Mile Road, Suite 303
Southfield, MI 48034
(248) 356-8790