Letter to a dental insurance CEO

March 21, 2012

A hygienist lays out many of the frustrations dental professionals and their patients face when it comes to dental insurance. Editor’s Note: The opinions reflected in this article do not necessarily represent the views of the editorial staff of Modern Hygienist and Dental Products Report. Photo: Getty Images Dear Sir,

A hygienist lays out many of the frustrations dental professionals and their patients face when it comes to dental insurance.

Editor’s Note: The opinions reflected in this article do not necessarily represent the views of the editorial staff of Modern Hygienist and Dental Products Report.

Photo: Getty Images

Dear Sir,

Thank you for taking the time to read my letter in regards to your dental insurance practices.   I’m just so thrilled to be writing this correspondence to you I don’t know where to begin!   Wait…I just began by saying how excited I am so I guess I do know where to begin. This is starting out better than I expected.

I’m a Registered Dental Hygienist. Guess where I worked before I became a licensed clinician? Don’t be a pooh-pooh head, sir…G give up? I worked in the dental insurance industry. I did; I fielded customer service complaints, graduated to claims processing, then I administratively assisted the dental director. I endured a lot of stress during that time, but I don’t want to dwell on the past. Instead, I want to talk about what I’m hearing today.

I’m sure this comes as no surprise, but I hear so many of my patients complaining about their insurance benefits:

“I can’t stop grinding my teeth but my insurance company won’t cover night guards.”

“I want to replace my broken silver fillings but my dental insurance won’t cover the tooth-colored ones on my molars.”

“My dental insurance company won’t cover implants. I’ve asked them to reconsider my dentist’s pre-treatment estimates but they said they can’t help me.”

And they’re not alone. I often find myself at a loss for words on how to respond. What would you have me tell them?

“Your dental insurance maximum of $1,500 hasn’t changed in decades-now that’s stability!

“There’s a reason your premiums are so high-so your dental insurance company can continue offering awesome, quality coverage.”

“I know your crown wasn’t covered but if your dental insurance company says it’s not then it’s just not. Perhaps you should floss more in that area, hmm?”

Those kinds of responses just won’t cut. A recent patient-someone you happen to cover-presented with an abscess, but was denied benefits for retreating his root canal. It was heartbreaking to listen to him talk about the intensity of his pain. There was nothing we could do besides prescribe more pain medication. That’s not my preferred way of “making it better.”

The sad story is, it turned out my patient’s abscess severely worsened over time. The infection got out of control and he subsequently had the tooth extracted. Your company wouldn’t cover the retreatment…but you covered his extraction at 40%! I try to tell myself that you know what you’re doing-after all, record profits can’t be wrong.

But they are.

Warmly,
Eva M. Watson, RDH       
 

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