Pennsylvanians spend a total of between $6-7.5 billion on dental care annually. Much of this cost is borne by insurers, yet most insured patients are not satisfied with their coverage, because they still pay for services that should have been covered. This is largely due to poor communication between insurers and dental offices. Coverage gaps, intentional or not, result in providers failing to receive full compensation for their work, and these costs are absorbed by the practice or passed directly onto the patient. By forcing dental staff to call and speak to representatives about patient history or benefits used, valuable time that could be used for office coordination and patient care is wasted and costs are increased.    
 

Additionally, insurance representatives often make mistakes or misrepresentations that ultimately result in loss of income for dentists when an insurance provider fails to honor their own representative’s statement. 
 

Frequently, dentists stop working with the insurers creating these problems, effectively forcing patients to switch practices or switch insurance providers. These moves are inconvenient and potentially expensive for patients, and carry no guarantee of better service or coverage.   
 

Requiring the use of provider portals would eliminate this problem. Some insurers already implement this tactic, but others have not prioritized integrating convenient communication with the services needed by their policy holders. Mandating regularly updated patient health history and coverage information, and clarifying that a statement of coverage creates reasonable reliance on that statement, would ensure dentists and patients both benefit. 
 

Join us in improving access to care and supporting the dentists of Pennsylvania. Give them back the same smile they give to you.