When assessing the strength of dental-insurance carriers, most people measure relative strength by the size of a carrier’s network. But is bigger always better – especially if bigger turns out to be not so big after all?
Network size can be measured one of three ways: by access points (the number of dentists practicing at all locations), by unique dentists, or by unique locations. Typically, reporting access points is the most popular method for measuring network strength; however, this provides an opportunity for errors and exaggeration.
One common source of inflated network listings is large multi-location clinics. These clinics typically employ a large number of dentists, with some dentists practicing at more than one location. That on its face does not cause problems; however, some dental-insurance carriers report every dentist associated with a large clinic as practicing at every location the clinic operates. When carriers engage in this practice, it is easy to see how network listings can quickly balloon far beyond what they truly should be.
Other common explanations for network inflation are easy to understand. Dentists can leave practices, move to other locations, get married, change names, retire, or die. While these are all normal life events, many carriers only update their network listings annually, or perhaps even less frequently. Inaccurate listings like this can then get picked up by data-mining services like NetMinder and reported as fact.
This chart delineates the inflation that can occur when carriers are not dedicated to maintaining accurate network listings. The chart shows several carriers’ network listings after being run against a list of verified dentist locations. Clearly, some carriers are better than others, but it is quite an accomplishment for Carrier A to inflate the size of a dentist network by 495 percent.
Delta Dental of Wisconsin takes network integrity very seriously. Delta Dental network listings are audited several times each year, and appropriate updates to provider listings are made in near real-time. By maintaining good relationships with our network dentists, we are able to call or visit offices to find out which dentists are actually practicing at those locations. Information submitted to us today is on our website tonight.
This type of commitment to accurate reporting – and network-building — has become a valuable point of differentiation for Delta Dental of Wisconsin. We enjoy showing the inner workings and subtleties of network measurement and management to our customers and agent partners. (Want to know more? Contact us.)
Big networks – genuinely big networks — are about more than just big numbers. They’re the end result of longstanding relationships with the dental community, integrity, and the commitment to use networks to deliver value. We’re proud of what our dentist networks represent. We hope you feel the same way.
