How to Drop Networks Successfully

Easy, right? Call the insurance company and tell them you are done. Not too fast… the complexity lies in how to do this without losing revenue. If you are fine losing patients who carry a given insurance company policy, then you likely can just drop and forget about it. However, most dentists and offices do not want to lose that many relationships, which is where planning correctly can make a major difference in your overall success.

Informing the insurance company is the first step most think about; however, it should be one of the last steps in the process if you want to mitigate loss of patients or income. When you drop a network, the insurance company is likely to send a letter to all the patients in your practice who are carriers of their insurance. This letter is geared towards undermining you as the provider and giving patients reasons to seek another in-network dentist who will continue to save the patient (as well as the insurance company) money. For this reason, it is important to focus on what to do before the insurance company is aware of your intentions.

What’s Your WHY?

To be successful in many aspects of life, one should focus on WHY you are making that choice. When it comes to insurance, this WHY needs to appeal to the patient, because they are who you’ll need to persuade to stay with you after you drop their insurance. “The insurance fees are too low” or “there are too many rules” are not reasons that will resonate well with a patient.

“We want to prevent insurance companies from pushing patients towards making poor health decisions.”

“Insurance is interfering with providing the high level of care our patients deserve.”

These are two good ways to structure the reasoning for dropping an insurance network. The key is to have a discussion with your team and find out the top reasons that would resonate with the patients whose insurance carrier you are wanting to exit their network. Then roleplay the likely discussions that will arise and questions that will come up. This allows your team to become more comfortable with the changes, as they are the ones who are going to answer most of the questions that arise, often daily, because of this major change.

What’s Your Plan?

Every good system is created by forming a sound plan before you get started. If you are in-network with multiple companies, dropping every insurance network at once might have drastic results and generate a tsunami of team challenges. It would be good to strategically plan out which companies you want to drop first.

One of the most common approaches I hear is “drop the carrier with the lowest fees first.” That sounds good and all, until you see that your lowest paying plan may be the one that half your patients are attached to and where most of your income comes from. When you are implementing a major change in your office, it is a good idea to start off slow. Allow the team to test reactions on a small number of patients first. If you are interested in shrinking your schedule, it might be a good idea to plan for dropping the insurance company with the largest total write-offs and understand you may lose a few more patients by not perfecting the process first. If you want to maintain your schedule or even still grow it, a good plan may be to start with the insurance companies with the fewest numbers of patients. This allows your team to get better at the patient discussion/Q&A process before dropping insurance of a larger number of patients. For an example, you might want to create a chart like this to help evaluate:

If you drop insurance A first, it has both the lowest losses (write-offs), as well as the lowest dollar impact on your office if something does not go well. It is the safest one to drop first due to the least number of patients and lowest total collections you might lose.

If you drop insurance D first, you will notice that you collect far more per treatment procedure as it is the largest network discount, but you stand to lose a large chunk of your office if something in the process does not work well. You might want to exercise caution before starting here.

Take Action

Once you have a plan as to which insurance companies to drop and when, then you can look at the implementation process itself and take proactive steps to mitigate potential losses. Spacing out the drop process among insurance carriers can help you minimize team challenges, questions, and in addition to losses. Giving just a few months between each network drop can help significantly.

Another consideration to think about is why your patient comes to see you. It will be a combination of network status and the relationship you have built with them. If you strengthen that relationship ahead of time, then the patient is less likely to leave once you change network status. Often this means increasing the logical and emotional value of the office. Actions you might take could include improving communications with additional staff training, increasing customer service, creating a niche for the office few or no one nearby does, and offering alternative solutions (such as in-office membership plans).

Final Thoughts

Dropping network status can be either the best thing you ever did or the worst. If you drop for the wrong reasons, with the wrong plan in place, or the wrong message you could stand to lose patients and revenue, sometimes more than you anticipate. Remember, insurance has their own contingency plan drawn up for how to communicate with patients when you drop their network. The best way to counteract their well-crafted strategy is to form your plan first and then personally talk to every patient in your office about what you will be doing and how it will benefit them (or at least not impact them much). To be able to do this means starting those conversations six months in advance, so you have time to see all your routine patients before a change happens.

The drop process itself will often take two-three months, so you can initiate the drop around four months after you start your series of patient conversations. The additional four months of prep time can mean the difference between massive patient loss and minimal loss.

This is Part 3 of a continued series. If you find that you are not ready to drop network status, then stay tuned for Part 4: Steps for Greater Success Staying In-Network

Read Part 1: FFS vs. PPO: Are You an Apple or an Orange?

Read Part 2: Are you Ready to Drop Networks?