New cloud-based software systems like Kleer are innovating subscription-based dental payment models.
With the ever-increasing complexity and limitations of dental insurance, modern-day dentists and practice-support staff often struggle to navigate the intricacies of exclusions, pre-approvals and proper documentation as they work to provide patient care and to receive reimbursement for care already provided. Likewise, patients often feel confused about their dental coverage, wondering if the seemingly mounting category of exclusions and limitations precludes them from accessing the care they desire.
Annual dollar limits determining how much treatment is covered add to the frustrations, particularly when a patient must pay for non-covered treatment while continuing to pay monthly premiums. Consequently, countless patients put off or opt out of treatment, leaving many dentists with outstanding collections and an unprofitable business model. It’s a system that, in the eyes of many, isn’t working.
In response, many dental practices are changing the way they do business. With dentists and patients alike seeking clarity, transparency and simplicity when it comes to payment for dental care, many are turning to insurance alternatives like dental membership plans that operate on a subscription basis. Not unlike the membership model seen at buying clubs such as Costco, Sam’s Club or Amazon, dental membership plans aim to hand treatment control and profits back to the dentist while making dental care accessible to all patients. The basic model sees patients paying a monthly or annual subscription directly to the dental practice, and in return, they receive a full year of preventive care as well as discounts off additional treatments.
As the concept has gained traction over the last several years, many dentists have begun implementing membership plans into their practices by independently creating and setting up their own subscription-based dental care options. In establishing such a plan, a practice sets its fee structure; plan inclusions, discounts and sometimes credits; renewal benefits; and extra discounts if partnering with specialists. Completely administered by the dental practice, these plans represent a significant step away from the frustrations so many experience with traditional dental insurance; however, self-created plans can come with their own set of challenges, particularly for dentists and their office staff.
A solution to those challenges and more appeared just a year ago with the introduction of Kleer, an innovative, cloud-based platform that makes setting up and overseeing plans easy, user-friendly and efficient. Plan design and customization is clear and simple. Kleer assists practices in designing and managing their own membership plans so that each practice defines its own prices, discounts, and inclusions.
Once the practice has selected what to include in its subscription service, patients have the option to join and the practice has a portal from which to manage the plan. Patients can join right at the reception desk or they can sign up on their own from any device. Once they join, patients then have access to the consumer side of the portal where they can view benefits, add family members and change payment options.
Kleer founder and CEO Dave Monahan likens the system to Uber, describing it as a platform that connects users to providers. “We are different in that we enable practices to design their plan themselves, making something that’s unique to each one,” he says. “[Practices] can design what’s included … set the subscription price … customize discounts by procedure categories … and customize options and add specialists with whom they’re associated. The bottom line is we have all the tools they need to create and customize the plan specifically for their practice.”
As part of the membership, all Kleer practices receive dedicated support from Kleer Success Managers, who are available to provide unlimited guidance, training sessions and assistance. In addition, Kleer provides all of the marketing materials a practice needs to promote the plan from email and social media templates to signs and buttons.
In describing what inspired him to create Kleer, Monahan - who hails from a dual background in technology and healthcare, with a particular interest in connecting the two - explains how a friend who works in dentistry lamented to him about the difficulties faced by today’s dentists. Intrigued by this conversation, Monahan initiated market research to study the habits of dentists and consumers, both insured and uninsured. It became clear to him that, overall, while dentists were struggling, uninsured patients wanted dental care but weren’t getting it because they were afraid of the costs. “They didn’t know what the costs were,” he recounts, “and they were afraid to go to the dentist and lie in the chair wondering what it was going to cost them. But membership plans remove that worry because they are clear, open and transparent.”
That ease and transparency are resonating well with dentists and patients, as evidenced by the more than 1,000 practices who have joined in fewer than 12 months. While initially conceived as an option for uninsured patients, Kleer has found fans among insured patients as well.
“Basically we’re seeing three groups of consumers switching over: uninsured patients, patients with poor dental plans that cover very ltitle or have ... many limitations and exclusions, and patients whose insurance has very low caps ... so patients are paying premiums and not getting the care they need. A membership plan simply makes more sense for them,” Monahan says.
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Dr. Richard Yarbro of Yarbro Family Dentistry in Spokane, Washington, implemented the plan into his practice in March 2018, less than three months after Kleer debuted. He and his staff are very happy with the program and patient response has been exceptional. Citing his practice’s history of working with uninsured patients, Dr. Yarbro is quite pleased with the streamlined and transparent way Kleer facilitates those efforts, making everything easier for patients and staff.
“There is less stress now,” he says. “No ‘haggling’ with uninsured patients. And I find patients are much more likely to follow my recommendations knowing how much it will cost or that it’s already covered under the plan. Kleer has been so easy to work with and our staff loves it.”
Monahan also says that the flexibility of the program has been well accepted by patients. “It’s nice having the option to pay monthly or for the full year up front. Some patients love to be able to spread their payment out, and some like the peace of mind of just paying for the whole year and being done with it.”
Several patients who had lost insurance have returned to the practice once they learned about the program. Dr. Yarbro says that one of his favorite moments was when a patient who had lost his dental insurance excitedly burst through Dr. Yarbro’s office doors after reading one of Kleer’s desktop promotional signs.
“He was so excited to not have to drop his dental care because he didn’t have insurance,” Dr. Yarbro says.
For now, Dr. Yarbro says that his primary focus will be working with his current patients who have no insurance. With almost a 100-percent signup rate, he says that his practice is completely maxed out.
“It’s comforting to know that if I did want to grow my practice, it would be easy to do so with the marketing material Kleer provides for all of their offices,” he says.
Monahan has also been extremely pleased with the acceptance of the program. Setting out with the goal of getting care to patients and revenue to dentists, he takes pride in knowing he’s a part of a much-needed change.
“Dentists are under siege right now and people just don’t seem to realize that,” he says. “In general, people have this perception of the dentist as a millionaire, but that’s just not the case. When you realize that 75 billion dollars are spent on dental insurance every year and that only 60 percent of that goes toward care, it’s nice to be doing something that puts the control and the money back where they belong.”
With both practice and patient acceptance running high, dental treatment plans will continue to grow and evolve. While each plan is unique to each practice, the underlying theme remains the same. Working hand-in-hand with platform-providers like Kleer, dental teams take matters into their own hands to make treatment uncomplicated, affordable and accepted.