Introduction: When Insurance Says “No,” It’s Time to Say “Heck No!”
You may be fighting Delta Dental Denied Claims! Picture this: you’ve just finished a flawless root canal, your patient is relieved, and then—bam!—you get a denial from Delta Dental. It’s like baking the perfect cake only to have someone slap it out of your hands. Frustrating, right? But here’s the kicker: insurance companies are now using artificial intelligence (AI) to deny claims faster than you can say “open wide.”
So, what’s a savvy dental practice to do? It’s time to reduce dependence on PPOs, ramp up your marketing game, and create a patient membership plan that makes insurance companies as relevant as a flip phone. Let’s dive into how you can take control and boost your revenue.
The AI Denial Game: Insurance Companies’ New Trick
Insurance companies have always been a bit stingy, but now they’re enlisting AI to do their dirty work. UnitedHealth, for instance, has been accused of using an AI model with a 90% error rate to deny care.
Similarly, Humana has faced lawsuits for deploying AI tools to deny claims.
These AI systems are designed to cut costs by denying claims en masse, often without proper human oversight. The result? More denied claims, more headaches, and less revenue for your practice. It’s like playing a rigged game where the house always wins.
Reducing Dependence on PPOs: Reduce Delta Dental Denied Claims
PPOs can feel like that clingy ex who won’t let go. They dictate fees, delay payments, and now, with AI, deny claims left and right. It’s time to break free.
Why Reduce PPO Dependence?
- Higher Reimbursements: PPOs often pay less than your standard fees. By reducing dependence, you can charge what your services are truly worth.
- Less Red Tape: Fewer insurance hassles mean more time focusing on patient care.
- Increased Revenue: Direct payments from patients lead to better cash flow and financial stability.
Ramping Up Marketing: Attracting Patients Without the PPO Middleman
With less reliance on PPOs, you’ll need to attract patients willing to pay out-of-pocket or join your membership plan. Here’s how:
- Optimize Your Online Presence: Ensure your website is user-friendly and SEO-optimized. Engage with patients on social media platforms.
- Offer Promotions: Provide special deals for new patients or discounts on popular services like teeth whitening.
- Leverage Patient Reviews: Encourage satisfied patients to leave positive reviews online. Word-of-mouth is powerful.
Creating and Growing a Patient Membership Plan: Your Golden Ticket
A patient membership plan is like Netflix for dental care. Patients pay a monthly or annual fee in exchange for preventive services and discounts on treatments. It’s a win-win.
Benefits for Your Practice:
- Predictable Revenue: Monthly fees provide a steady income stream.
- Patient Loyalty: Members are more likely to stay with your practice and accept additional treatments.
- Reduced Insurance Hassles: Less dealing with claim denials and more focus on patient care.
Benefits for Patients:
- Cost Savings: Discounts and included services make dental care more affordable.
- No Insurance Headaches: No dealing with claim denials or coverage limitations.
- Better Health Outcomes: Regular visits lead to better oral health.
Case Study: 7 to 7 Dental’s Membership Success
7 to 7 Dental has mastered the art of the membership plan & doesn’t have to deal with Delta Dental denied claims as much. They boast over 3,800 active members, each paying $45 per month. That’s a whopping $171,000 in monthly recurring revenue (MRR) and over $2 million in annual recurring revenue (ARR).
Impact on the Practice:
- Increased Patient Spend: Membership patients spend an average of $2,200 per year, compared to $500 for PPO patients—a 4.6x increase.
- Financial Stability: Predictable income allows for better financial planning and investment in the practice.
- Reduced PPO Dependence: With a strong membership base, the practice isn’t at the mercy of PPOs and their AI-driven denials.
Case Study: Wood River Dental’s Referral Magic
Wood River Dental has taken a different approach by leveraging referral marketing to grow their membership base. They have over 800 members, each paying $45 per month, resulting in $36,000 in MRR and $432,000 in ARR. This allows them to be strategic and allow them to drop insurance companies and reduce Delta Dental denied claims
Impact on the Practice:
- Increased Patient Spend: Membership patients spend significantly more annually compared to PPO patients.
- Community Engagement: Referral programs have strengthened ties with the community, leading to more word-of-mouth referrals.
- Financial Growth: The steady income from memberships has allowed for expansion and investment in new technologies.
What is BoomCloud™ and How Can It Help?
BoomCloud™ is a software platform designed to help dental practices create, manage, and scale patient membership plans. It automates billing, tracks member benefits, and provides analytics to help you grow your program.
How BoomCloud™ Can Help You Scale:
- Automation: Handles recurring billing and renewals, so you don’t have to.
- Analytics: Provides insights into member behavior and revenue trends.
- Marketing Support: Offers tools to promote your membership plan effectively.
Conclusion: Take Control and Thrive – Delta Dental Denied Claims
Insurance companies are using AI to deny claims faster than ever, making it crucial for dental practices to reduce dependence on PPOs. By ramping up your marketing efforts and creating a patient membership plan, you can take control of your revenue and provide better care for your patients. Learn from the successes of 7 to 7 Dental and Wood River Dental, and consider leveraging tools like BoomCloud™ to scale your membership program. It’s time to say goodbye to the headaches of insurance denials and hello to a thriving, patient-focused practice
