22 MiMfg Magazine July 2021
Premium Associate Member
How Good is Your Dental Network ? Ask 3 Questions to Find Out
What ’ s the first thing almost every employee does when introduced to a new dental benefits plan ? They look to see if the dentist they want is on the network list . If they are , it must be a good plan , right ?
Of course , offering dental benefits with provider networks that include the dentists the employees want is essential for benefit satisfaction . But it ’ s not the only factor you should consider when evaluating dental networks .
“ A dental carrier ’ s dental network is one of the most important aspects of an employee dental benefits program that employers , brokers and consultants evaluate because it is a key driver to employee benefit satisfaction ,” according to dentist Dr . Dave Guarrera .
Asking three key questions can help you uncover how hard a provider network will work for your company and your employees .
1
What are the average in-network discounts and in-network utilization rates ?
Discounts are always important . But make sure they ’ re meaningful . By evaluating both in-network discount amounts and network utilization , you can get a reliable measure of the network ’ s strength and value . Utilization percentages show how often the discounts are getting used , which can drive down plan costs and out-of-pocket expenses — and drive up satisfaction as well as savings 1 for employees .
MetLife ’ s dental plans include network discounts that average 30 to 45 percent below community average charges . 2 When you factor in our high in-network utilization of 67 percent nationally , which averages 16 percent higher than others 3 , it shows we ’ re offering deep discounts on the dentists that employees are seeing most often .
Dr . Guarrera backs this up from a dentist ’ s perspective , “ MetLife ’ s network is built upon great access to a large number of dentists who are contracted with deep discounts and who have been rigorously screened to ensure they are providing appropriate care .”
How does the dental carrier review
2 and monitor their dentists ?
A network is only as good as the quality of the dentists who participate . That ’ s why the vetting , education , and monitoring of network providers is essential to ensuring a stable network that helps provide employees with access to appropriate and consistent care .
Ask about the provider ’ s rejection rate for dentists applying to join the network . Then , look at the network ’ s voluntary turnover rate to better understand the overall stability .
For example , MetLife typically rejects around 9 percent of provider applications up front , which is more than the industry average . 4 Our focus is on ensuring dentists are a good fit for our network before they even join . So , we do extensive reviews to analyze the licensing , sanctions , malpractice history and overall practice patterns of each provider .
After dentists are accepted into the network , they ’ re re-credentialed every three years and continually monitored . 5 As a result , the MetLife network ’ s voluntary turnover rate is quite low — 0.4 percent — and our involuntary turnover rate is only 0.8 percent , compared to industry averages for dental network turnover of around 4 to 7 percent annually . 2 , 4
Based on our provider review and monitoring processes , we are confident that our network of more than 440,000 dental access points nationwide includes not just a lot of dentists but also the best dentists .
What kinds of cost protections
3 does the carrier have in place ?
Comprehensive cost protections help prevent dentists from inappropriately billing patients for dental services at the point of claim , which helps prevent the erosion of discounts and value . Seek out information on how the carrier handles dentists with unusual billing patterns . And find out whether the carrier extends discounts when maximums or limitations are exceeded . MetLife ’ s network providers are held to our discounted fee schedule so there are no unexpected costs , even if a plan participant exceeds the annual maximum benefit and frequency and age limitations .
It ’ s the combination of network size , discounts , quality and cost protections that give a dental network the power to drive satisfaction and savings 2 for your business and your employees . By answering these three questions , you ’ ll get beyond the number of dentists to determine a dental network ’ s true value . 6
Sources
1
Savings from enrolling in a dental benefits plan will depend on various factors including the cost of the plan , how often participants visit the dentist , and the cost of services rendered .
2
Based on MetLife internal data .
3
Dental Actuarial Analytics , Dental PPO Network Study , 2018 edition .
4
Ruark Consulting Dental PPO Network Study , 2018 edition .
5
Subject to applicable law .