Dear Friends and Loyal Patients,
We are now in the first month of discontinuing my contractual relationship with Washington Dental Service (WDS). We would like to share some more information about this dilemma that we have learned just recently. Please remember that WDS is the one who has changed the rules for both the providers and the employee/patients. They had contracts with both the dentists and your employers that have been altered significantly. I now believe that they have become so big and powerful that they believe they can play by any set of rules that insures increased profits—that’s how they define “insurance”. Let me show you how WDS has found a two-headed coin so that every time they flip it- they win.
Let’s put dentists on one side of the coin. As you remember from my last letter, WDS has changed their contract with dentists by a 15-22% decrease in allowed fees. So with the WDS ‘fee freeze’ of almost 3 years, this decrease set my fees back 10 years. Unfortunately no one has frozen my monthly bills or set them back 10 years. I submit that a dentist trying to continue business under these circumstances must seriously compromise care to stay in business. So for example let’s say you chose to see a WDS preferred provider (PPO) dentist. If WDS was contracted by your employer to pay $100 to a dentist for a service, after June 15 WDS only has to pay $78. The dentist loses because of the fee decrease. The employer loses because they already paid for the employee benefit of $100 and now it’s $78. The employee/patient loses because the quality of care has been decreased. WDS is the only winner as they make up to 22% more profit for doing nothing but changing the rules.
Now put the employee/patient on the other side of the coin. For example let’s say you chose to stay with your dentist who is now ‘out of network’. If WDS was contracted by your employer to pay $100 to a dentist for a service after August 1(the date I left the network) they will only pay a much smaller amount than the $78 in the above example. We have just learned they are decreasing their allowed fees between 30 and 60% depending on the service. This means of that $100 they might only cover $40. The employee/patient loses because now they have to cover that difference between the $100 and the $40. The employer loses because again they have paid WDS for a $100 benefit for their employee who now is only getting a $40 benefit. The dentist is also a loser because even though our fee is not decreased in this example, the financial hardship and confusion that has been placed on the employee/patient has and will alter the flow of dental health care. Again WDS is the only winner as they now make up to 60% more profit. So if you multiply their increased profit ratios of 22-60% by the many different dental procedures and then multiply that by the hundreds of thousands of employee/patients they cover you quickly get to some incredible numbers. Sound fair? Either way the coin lands, they win!
So how do other insurance companies treat this relationship between PPO and ‘out of network’? In my 20 years of dental practice I have only contracted with WDS, no other insurance companies, though we have always had many patients who have chosen to come to our office even if I was not a PPO provider. Right now there are 20 or so of those different insurance companies that send me payments for treatment of their clients. On average those insurance companies discount my current fee schedule 8%. So those patients are responsible for that 8%. From the examples above WDS is discounting up to 60%. No other insurance company that I know of treats their clients(you) with such a penalty for retaining your freedom of choice in the patient/dentist relationship. In my opinion this is a strong-arm tactic to instill enough ‘financial’ fear in the dentists and you so that we forget about choice.
We have many patients that are upset with the current situation they are in and many others are still confused. My main point of all this ranting is to suggest that if you are concerned or confused about the intentions of WDS please contact your HR department and let your voice be heard.
- Ask why have my benefits changed/decreased in the middle of the year.
- Also ask if at least ‘the company’ is getting some kind of refund from WDS and/or if their premiums have been reduced.
-Ask for an insurance option that does not take away choice.
Again this is not your employers fault but it seems from our perspective that there has been a lack of concern on the employers’ part. I suspect that WDS has been telling companies something to the effect that now they will be able to hold premiums in place for some time into the future, which your employer would be thrilled to hear, but all the while WDS will be extracting huge profits out of Washington State dental healthcare and ultimately our own community.
I must end on a happy note. Thank you for working with us during this difficult and confusing time. I look forward to continuing to serve you and your family for many years.
Sincerely,
Rory A. Knapp DDS