For Dentists: Essential Things to Know About Your Dental Insurance Contract

Essentials of Dental Insurance ContractA majority of dentists see negotiating with their insurance providers as a tedious and impossible task. This is why, unfortunately, most choose not to do it. However, this usually results in poor contract provisions — if the dentist even knows what’s really in the insurance contract in the first place.

To break this cycle, pay close attention to the following when looking over your dental insurance contract:

  • Contract Duration: Majority of providers will require long-term contracts, but while this is the norm, it’s crucial that you know exactly how long the contract will take effect.
  • Contract Provisions’ Legality: All provisions must be in complete compliance with all applicable statutes.
  • Comprehensive Services Description: Make sure that you obtain in writing all duties that your insurance provider must fulfill, and whenever possible, how long the provider will provide these particular services or duties. This will be especially useful when you negotiate your dental insurance contract.
  • Payment Schedule: You should know about the right for refunds that require complete payment upfront for specific services.
  • Termination Rights: Know if you’re capable of terminating your contract.
  • Services or Product Ownership: In the event that the service included in your contract is a provision of a particular product, like a domain name or website, you must determine if your provider considers your ownership of the particular product provision or if ownership is limited to your contract’s duration and be wholly owned by your provider once your contract expires.
  • Automatic Renewals: You should be aware of provisions for automatic renewals so you can preplan for either the termination or continuance of your contract.
  • HIPAA-Compliant Patient Data: In the event that your insurance provider gains access to your patients’ details, you should discuss HIPAA (Health Insurance Portability and Accountability Act) compliance issues with your provider.
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Understanding what’s included in your dental insurance contract is necessary so you know exactly what works for you and what exactly you’re entitled to. In addition, this is excellent practice in the event that you choose to negotiate your dental insurance contract in the future.