08/04/2008
Insurance company flexes its muscle and points to the bleachers
Children pay the price when insurers play hardball.
The NFIB/Indiana phones began ringing off the wall in the last few weeks with calls from many of our dentist members. It seems that Delta Dental, the largest dental insurer in Indiana, has recently come out of the dugout swinging, and NFIB members are involved in a squeeze play.
What's going on?
In order to force providers into joining their network, Delta Dental has sent notice to Indiana dentists that effective June 1, 2008, they will no longer send checks to dentists who choose not to belong to their network. They will send the insurance payment to the patient who will then have to send a check to the dentist.
So what's the big deal?
It's a big deal because it is a hardship on the patient. Dentists may be forced a request payment in full at the time of service because, in many cases, they will never receive payment from the insurer.
It's a big deal because it will drive up the cost of dental care. The longer it takes a dentist to be paid, the more he will have to charge for his/her services. The result will be higher cost for healthcare.
It's a big deal because it takes the provider out of the loop. If there are any hold-ups on the insurer's end that require follow-up, the dentist will not find out until the patient notifies him, sometimes months down the road.
It's a big deal because it is a matter of choice. The patient should have the right to request that payment go to the dentist. Delta Dental says it will not honor a patient's request to have benefits assigned to the provider.
It's a big deal because it affects the health of children. When the check goes to the family, the check will often be spent by the parent because every growing family needs money. Then the family owes the dentist, can't pay the bill and the child doesn't return to the office. The kids ultimately pay the price.
The squeeze play
Frankly, when I first heard about this issue, it took me a little while to get my head around it. Unless you are directly involved, it can be hard to understand.
Delta Dental will claim that the assignment of benefits to the dentists will destroy their network. They will assert that dentists have no reason to sign up with them if they are paid directly whether they are in or out of the network.
This is simply false. That has not been the case in a number of states that have passed some sort of assignment of benefits legislation. Additionally, the reason patients are driven to a network is because more of their bill will be covered by the insurance plan.
The bottom line
Delta Dental is playing hardball to get the dentists in line. These strong arm tactics will cause the cost of dental care to go up and patients and their families will suffer.
The rumor mill
Remember early this year when I warned you about the precarious situation with the Unemployment Insurance Trust Fund (UITF)? Looks like the fund will run out of money in the first quarter of 2009. Look for a big fight over this issue in the next session. Some folks are going to try and hand the check to small business. We're going to need the help of activist members to fight a UITF tax increase.
Dates to remember
Oct. 7, 2008: NFIB/Indiana Leadership Council meeting. Skyline Club, Indianapolis
Oct. 9, 2008: Last day to register to vote in the November elections
And furthermore
Please give me your feedback. I enjoy hearing from you and I appreciate your comments. Thank you for being an NFIB member and for reading "Capitol Capers."
Barbara Quandt
NFIB Indiana State Director
317-638-4447
Barbara.Quandt@nfib.org
