Point of Service Plans, with Patrick O’Rourke, Host of Dental Business Radio
Patrick O’Rourke, the host of Dental Business Radio, uses an automobile analogy to explain Point of Service Plans available to dental patients.
You can find the video of this episode here.
Dental Business Radio is underwritten and presented by Practice Quotient: PPO Negotiations & Analysis and produced by the North Fulton studio of Business RadioX®.
About Dental Business Radio
Dental Business Radio covers the business side of dentistry. Host Patrick O’Rourke and his guests cover industry trends, insights, success stories, and more in this wide-ranging show. The show’s guests include successful doctors across the spectrum of dental practice providers, as well as trusted advisors and noted industry participants. Dental Business Radio is underwritten and presented by Practice Quotient and produced by the North Fulton studio of Business RadioX®. The show can be found on all the major podcast apps and a complete show archive is here.
Practice Quotient
Dental Business Radio is sponsored by Practice Quotient. Practice Quotient, Inc. serves as a bridge between the payor and provider communities. Their clients include general dentist and dental specialty practices across the nation of all sizes, from completely fee-for-service-only to active network participation with every dental plan possible. They work with independent practices, emerging multi-practice entities, and various large ownership entities in the dental space. Their PPO negotiations and analysis projects evaluate the merits of the various in-network participation contract options specific to your Practice’s patient acquisition strategy. There is no one-size-fits-all solution.
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TRANSCRIPT
Patrick O’Rourke: [00:00:00] Hi. This is Patrick O’Rourke. We’ve been getting some questions and I’ve been asked about dental insurance, Point of Service Plans or the acronym POS.
Patrick O’Rourke: [00:00:13] Point of Service Plans sort of look like a PPO. They’re a hybrid between a PPO and HMO. Interestingly enough, in the medical world, these are very popular, particularly in metropolitan areas, but it looks like a PPO and then it’s put on an HMO chassis. Where, in the dental insurance world, it looks like, more often than not, they’re trying to make an HMO and cram it onto a PPO chassis, albeit a very low reimbursing PPO in most cases. All right.
Patrick O’Rourke: [00:00:00] So, the POS or the Point of Service Plan in dental insurance looks like a PPO, but the out of network benefits are going to be skewed heavily, so it’s going to incentivize or steer you in network. And then, if it says something like when you go out of network, the out of network allowable is going to be whatever we want it to be, then you’re going to get dinged again.
Patrick O’Rourke: [00:01:16] So, it’s not just the percentages are less, but also whatever they decide the allowable rate is for that plan, which probably will not be disclosed to you until the transaction or the insurance transaction is complete, is very likely to be even less, which is going to hurt the provider and cause a big balance bill for your patient.
Patrick O’Rourke: [00:01:45] I like analogies, so let me use another analogy. So, POS means something in the automobile world too. And it is not altogether uncommon for companies to give a company car as a perk, as a way to attract and retain talent. Much like dental insurance is a benefit for the employees, for them to come in and say, “Look we got great dental insurance and so here’s our point of service.”
Patrick O’Rourke: [00:02:19] If I’m using an analogy for the layperson out there that’s listening to this for whatever reason, it would your new boss is, “Welcome to the team. We’re going to give you that company car.” And then, he walks you out there to the car lot outside in the parking lot and it’s a Yugo. That’s a POS in the automobile world.
Patrick O’Rourke: [00:02:46] I hope that’s helpful. Until next time.
