Payor Profiling Instrument Finally Complete

Payor Profiling Instrument Finally Complete

Cameron J. Jayson, D.D.S.:

Report from the Dental Marketplace Committee

The Minnesota Dental Association’s Marketplace Committee has given final approval to the third party payor profiling instrument developed in collaboration with MORI Research. The survey of our members’ experience with various managed care plans will be sent via e-mail in the near future. The committee asks that the members look for it in their incoming e-mail. The survey is easy to complete and takes only a few minutes. The MDA will share the results of this payor report card as the information is tabulated. Please complete it and send it back as soon as possible.

The subcommittee of the Marketplace Committee that has studied the corporate ownership of dental practices has finished its work. As you recall, the issue surfaced with the Park Dental lawsuit. An article will be submitted to Northwest Dentistry in the near future outlining the issues and the potential concerns. Along these same lines, the MDA Marketplace Committee has recommended to the Board of Trustees that they establish a task force to work with the Board of Dentistry. The Board of Dentistry has extended an invitation for the MDA to work with them to try to resolve the issues involved with the corporate and non-dentist ownership of dental practices. Stay tuned as to what the MDA Board of Trustees and the Board of Dentistry develop.

In addition, as most of you know, DeCare Dental was acquired by Wellpoint in 2008. The MDA will be closely watching how this acquisition will impact our marketplace and will keep you apprised of any further developments.

Over the past two months, I have been contacted by several dentists who are being audited by managed care companies. Either the audit frequency is increasing or the reporting of audits is increasing. I am not sure which is the case. For the memberships’ information, two practitioners phoned me in June. Both were audited by Delta of Minnesota. Both recovery requests were substantial. One was in six figures, the other in seven.

If you are scheduled for an audit by any managed care company, there are specific actions you should accomplish, preferably before the audit starts. The MDA has a checklist of actions to aid you in an audit. Furthermore, the MDA can give you the names of experts and legal counsel to help you get through the audit.

Practicing in a profession is somewhat like running a relay in a track race where each runner passes the baton to the runner next to run. I have run hard in this race, banging my knees on occasion, and banging into others as well. But it is time for me to step down from the Marketplace Committee, and let a younger runner take the baton. My father used to say that passion for work was like “fire in your belly”. I am hopeful the next relay runner will have that fire. Thank you all for your support and encouragement, and even that tough criticism on occasion, during my seven years on the MDA Marketplace Committee.