Win-Win: Dental benefit consulting adds value for insurers

June 1, 2008

Dental benefit consultants are important allies for insurers as the dental profession transitions to an evidence-based dentistry (EBD) perspective.

Dental benefit consultants are important allies for insurers as the dental profession transitions to an evidence-based dentistry (EBD) perspective. Although many dentists feared that EBD would lead to coverage restrictions; in reality, EBD has led to expanding coverage for preventive treatments. Delta Dental, Aetna Dental, Cigna Dental and Vision and UnitedHealthcare Dental are among the providers that have added reimbursement for procedures due to EBD. Dental benefit consultants are helping to drive the shift to EBD by championing EBD within insurance companies and with dental colleagues in the field. At the same time, since many dental benefit consultants remain in private practice and retain their ties with practicing dentists, they are in a unique position to share positive views of EBD and to lead by example by incorporating EBD into their own practices.

EBD encourages dentists to apply research and techniques of scientifically proven best practices in everyday patient treatment. The goal is to make proven and scientifically valid advances in dental science and clinical practice accessible to practicing dentists. Champions of EBD hope to improve patient outcomes, reduce treatment disparities, and contribute to the good of the profession and its patient population.

Dental benefit consultants also provide a valuable service to insurers by encouraging collaboration and positive dialogue with practicing dentists. Since dental benefit consultants have ties to practicing dentists and insurers, they can help each side better understand the other. By helping to decrease the tension and mistrust that sometimes exists between dentists and insurers, dental benefit consultants can help to create a healthy professional climate. Diffusing mistrust and building opportunities for dialogue makes it easier to achieve positive resolution for claims processing issues, resolve reimbursement problems, and create improved policies and standards that benefit everyone involved-including the patient.

The AADC's goal is to work with organized dentistry to meet the challenges of our rapidly changing profession and the evolving technologies that affect it.

Robert S. Laurenzano, DMD, FAGD, is a certified dental consultant, AADC president and dental director, UnitedHealthcare Dental.

Dr. Laurenzano writes in his capacity as the President of the Association and not as a Dental Director for UnitedHealthcare Dental