In the 1990's along came the invention of the HMO (Health Maintenance Organization) in both medicine and dentistry. HMO's were new and no consumer really understood how they worked. All the consumer knew was that they paid a lot less in premiums and received a lot of services for free. What the consumer didn't know hurt them: when you join an HMO you have been put on a list that has been assigned to a specific dentist. Most likely this meant that you had to change from your usual dental provider to one that was also on a list. The dentist is paid a monthly amount to see the patients on his or her list.
There are many problems with trying to provide dentistry this way. The first is the list, which is usually out of date. If a patient has selected an office but has not yet appeared on their insurance company's list then the dentist is not obligated to see the patient. The second is that the provider list is always out of date. Dentists who appear as providers on the list may have dropped their participation or are no longer accepting any new assigned patients. The lack of organization within the insurance companies hurts the patients: they are paying huge monthly fees but are no longer able to get services rendered in a timely fashion or at an office nearby.
Then there was the invention of the DMO (Dental Maintenance Organization). This is similar to an HMO, but instead the dentist charges a percentage of their usual fees to patient's with DMOs. To counter this, dentists began raising their fees for most services, many times doubling their fees so they wouldn't lose money to DMOs. Patients without dental insurance would have to pay extraordinary amounts for certain services. This caused a ripple effect throughout dentistry because dentists' fees were rising 10% to 25% per year when inflation was less than 5%. Dentistry became much more expensive because of HMOs and DMOs. For example: a crown in 1990 would go for around $500, but by 2000 a crown cost over $1000.
When I opened my office in 2001 we accepted several HMO/DMO programs. By 2005 we had become so overwhelmed by the same programs and decided to discontinue our participation. We still accept hundreds of insurance programs: Delta Dental is the creme de la creme of dental insurance companies on my hate list. This company has not raised the amount they pay dentists for certain services in over eight years! They are so difficult to work with that many Delta Dental members can no longer find participating dentists nearby. This is unfair to the dentists and unfair to patients who are now, thanks to insurance companies, forced to pay exorbitant amounts of money for dental work regardless of whether or not they have insurance.
So we came up with our Family Plan- a reduced fee plan available only at my practice. The patient pays us a yearly fee, usually less than the premiums for an HMO/DMO, and in exchange receives cleanings, exams, and x-rays for free. They also receive a substantial discount on our other services. We have been able to provide the same program with no increase in per year membership ever. It's still just $99/ year!
A Family Dental Care Center: Dr. Seth Rosen
2030 West Main St. Norristown, PA 19403