Dental costs and insurance are a mystery to many consumers. You can help demystify them by making your patients aware of our free, award-winning consumer website, fairhealthconsumer.org, which can play a useful role in your own communications with your patients.
Lack of Knowledge about Dental Costs
Even for the 64% of Americans who have dental insurance, there is often confusion as to what services are covered and how much the insurer will pay. For those who do not have dental benefits, lack of knowledge of the costs of care, and fear of high prices, may keep many from seeking the dental care they need.
FAIR Health data indicate that emergency department (ED) visits for two CPT1 codes—99284, ED visit, high/urgent severity, and 99285, ED visit, high severity and life-threatening—that are associated with dental diagnoses have risen from 2011 to 2015. That suggests that people are increasingly postponing dental care until they develop serious health issues.
The problem of not knowing dental costs is particularly pressing for older adults. Upon retirement, many of them lose whatever dental benefits they may have had from their employer, and Medicare, the public health insurance program for the elderly, does not cover most dental services. Most older adults are left to pay their dental costs out of pocket, precisely at a time when their dental expenses are likely to be higher than ever. According to AHRQ data, from 2000 to 2010, per-patient annual dental expenditures rose from $655 to $796 among adults 65 and older, compared to an increase from $557 to $644 among adults aged 21 to 64.
Informing the Consumer
To make informed decisions and budget for their care, consumers need to be able to estimate ahead of time how much the dental procedures they need are likely to cost. FAIR Health’s FH Consumer Cost Lookup tool, the centerpiece of its consumer website, allows consumers to estimate their out-of-pocket dental or medical costs for free, based on prevailing market charges in their specific geographic area. With this information, they can plan financially for dental work they are considering or know they will need. They may even use the information to negotiate discounts with dentists.
The rest of the website offers background information in plain language on health insurance coverage and costs, including articles on dental plans, dental coverage for children and paying for orthodontics, as well as a glossary of dental procedures and services. Thus, the website provides resources, from a neutral, independent source, to guide consumers though the dental care system, in addition to allowing them to estimate the cost of the dental work they may need. The website is in English and Spanish. It also is available as an English or Spanish mobile app.
The website has received multiple honors, from such sources as AHRQ, the White House Summit on Smart Disclosure, URAC, the eHealthcare Leadership Awards, and AppPicker. Most recently, Kiplinger’s Personal Finance named our cost lookup tool the best “Health Care Cost Estimator” on its “Best List” for 2016.
Improving Your Practice with Access to Information
Helping your patients get access to cost estimates and increase their dental insurance literacy can be a win-win for both of you. Their trust in you is likely to grow, improving your relationship with them; they are less likely to avoid procedures out of fear of unknown costs; and they are more likely to budget for procedures appropriately, simplifying collection and billing disputes.
In addition to referring patients to FAIR Health’s free consumer tools, you can make an even greater impression by offering them to your patients at no cost. If you license FAIR Health dental data for your practice management needs, you can offer such materials with your own brand and messaging.
Knowledge is power, and consumers need and deserve that power with respect to dental costs and insurance. They will be grateful to you for showing them the way to it. Contact firstname.lastname@example.org to learn more.
- CPT © 2015 American Medical Association (AMA). All rights reserved.
Robin Gelburd, JD, president of FAIR Health, has published numerous articles on topics such as data analytics, healthcare cost transparency and clarity, the New York consumer protection law, and consumer preferences. Prior to her role at FAIR Health, she served for 8 years as general counsel of a medical research foundation comprising approximately 30 premier academic medical centers, hospitals, and research institutions in New York. During her tenure at this consortium, she also was appointed chairperson of New Yorkers for the Advancement of Medical Research, which she helped found in 2003. Previously, she was a health law partner at Kalkines, Arky, Zall & Bernstein (now Manatt, Phelps & Phillips). Earlier, she worked as a litigation and corporate associate at the international law firm of Morrison & Foerster. She began her legal career as a federal appellate law clerk to the Honorable Francis D. Murnaghan, Jr. from the Court of Appeals, 4th Circuit.