What is “Plan B?” The New Normal in a Post-Irma World

By a Fellow FDA Member

Call it intuition, but I had the feeling we —and the entire east coast of Florida — dodged a bullet last year with Hurricane Matthew. It just seemed like a matter of time before our 13-year dry spell was going to end.

I desperately wanted to be wrong, as I watched CNN every evening for the latest update on Hurricane Irma, and the National Hurricane Center for the more elaborate interpretation.

The memories of spending another post-Labor Day weekend away from home (Hurricane Frances, 2004) sadly is still too vivid in our memories. I worked as a dentist a total of four days that month, and two of those were without air conditioning — which is a testament to the determination of my staff and my patients to create a sense of “normalcy” in the aftermath, despite the obvious disruption to our personal lives.

Doctors, it is time for “Plan B.”

Depending on where you are in your practice career, it may not make economic sense to “build over” before or after your insurance adjuster has given you the final assessment. For dentists with more than 25 years of practice, the return on investment may not be in your favor at such a late period, as the current tax laws for business owners after 50 provide decent “catch-up” provisions in a defined benefit (like a government pension) and defined contribution (401K-type) plans that would be more beneficial.

For a mid-career solo practitioner, you have been faced with rising overhead costs since 2007, and along with diminished income (ADA Health Policy Institute has the data), the time is ripe for a multi-doctor practice formation, which should always be created with expert legal and financial advice.

Look “around the neighborhood” and reach out to other dentists who may share the same dilemma you do. If you have damage to your office, and someone nearby does not, now would be the time to construct a well-defined contract that outlines the term and time limit for this new arrangement. And if the relationship works on a limited basis, you may find the new arrangement something you want to solidify.

Likewise, if your office came out unscathed, reach out to your colleagues in this period and strategize. This is not a DIY project, so retain the professional advice you need to make this happen. Involve your bankers and financial advisors for expert advice.

In closing, I want you to know that I understand what you have gone through, and I look at 2004 as a defining year in my professional career. The decisions I made after these disasters guided me to where I am today, and my family is better for it.

Make the right choice for your loved ones and your staff members, and don’t be afraid to execute “Plan B!”

 

 

An Early Bite with Dr. John Paul: “Are You on My Insurance?”

By Dr. John Paul, FDA Editor

What do you want your staff to say when a patient asks some variation of, “Why aren’t you on my insurance plan?” This is usually asked with the hidden threat or just basic confusion that they have to go where their insurance says.

“Mrs. Gruntbuns, if Dr. Paul were to be ‘on your insurance’ he will be required to sign a contract with your company that will dictate how he behaves when he sees you. Sometimes it may be just as simple as what to charge when, but it could mean he can’t provide a service that might be the most appropriate service for you. Because he believes no one should interfere in his relationship with you, he is unwilling to sign such a contract. That said, we will work with any insurance company that can provide your benefits in a timely manner without undue interference; we just aren’t ‘on your plan.’”

If you are a preferred provider for some plans but not all, you can use this same wording. Just note that you have reviewed the contract you will be required to sign and feel that unlike other plans you accept, this one will put unnecessary stress on your doctor-patient relationship.

Have a question you have a tough time answering? Send it to Dr. Paul at jpaul@bot.floridadental.org.

Claim Scenario: Hired and Non-owned Auto

By Heidi Stearn, The Hartford, Outpatient Healthcare Program Director

Dr. Smith has a patient coming in for her dentures at 11 a.m. It already is 10:30 and the dental lab still has not dropped them off at the office. Dr. Smith does not want to reschedule the patient, so he asks his receptionist to go to the lab to pick them up in her car, which usually occurs a few times a week. As soon as the receptionist pulls out of the driveway, she rear ends another car. After calling the police, the receptionist realizes the other driver has no insurance and she knows the other driver is going to be looking for her to cover the damage and medical bills. Without thinking, the receptionist indicates that she was just leaving the dental office to pick up the dentures and feels awful about the accident.

A few months pass, and Dr. Smith receives a letter in the mail from an attorney indicating he is responsible for the damages his employee caused, given she was in the scope of work. Dr. Smith quickly calls his insurance agent and learns that he has hired/non-owned coverage and he won’t have to pay anything out of pocket, given this accident occurred in the scope of employment. If he did not have this coverage, his practice could be held liable for the damages that his employee caused. Make sure your office insurance policy has hired and non-owned auto liability insurance!

Heidi Stern is responsible for working with FDA Services on the insurance program. Call FDA Services at 800.877.7597 today for more information.