Determining the Ideal Fee Schedule Standard for Your Practice

Keep your practice running efficiently and in line with local standards

Many dentists often wonder how often they should be comparing their fees to the industry standard. At a minimum, dentists should be running a comparison at least once a year. However, I strongly recommend looking at them at least twice yearly. There are a couple of reasons for this. Some insurance companies update their fee profiles twice a year, so it benefits you to update yours as often as they do to make sure you’re being reimbursed as fairly as possible. Also, adjusting your fees more regularly allows you to raise fees more slowly and gently, which prevents your patients from getting “sticker shock” at the rising price of their dental care.

Finding the Optimal Fee Survey

There are a number of surveys available to dentists, and it can be difficult to determine which survey provides the most accurate information. There are several reasons one survey may be more valuable than another. The fact is the more localized the survey, the better. It’s that simple.

Think about where your practice is located and the people who live and work around it. The factors that determine cost-of-living in each area are so complex and varied that there’s really no way to assess it without going town to town. Many of the fee schedules that I’ve seen use zip codes to localize their information, and that’s really the only way to do it with any sort of effectiveness. It’s great for comparing where your fees stand in relation to other offices in your area. You know when you’re looking at a localized survey that it’s an accurate assessment of what your competitors are charging.

When setting your fees, again, it’s really about where you are relative to the average fees in your area. In particular, you want your UCRs to be in the 80-100th percentile of whatever is average. This is especially true if you’re going to offer promotions like senior savings, cash discounts, Care Credit or Quality Dental Plan, the system I developed.

Creating a Win-Win Scenario for Your Patients & Your Practice

In fact, I created QDP in part to make setting my fees easier. I didn’t like being forced to charge fees that were lower than Usual, Customary and Reasonable. I found that many of the insurance companies were offering fee schedules so low that it was prohibitive to running my business at a quality level. I was suffering and my patients were suffering. The insurance companies were the only ones benefiting. Plus, you have to remember that depending on your area, up to 60% of your potential patients don’t have insurance. I wanted to be inclusive of all patients in my area, not just those on a particular dental plan.

QDP was the answer. Patients these days are looking for value. QDP creates value for those patients who enroll, giving them access to a reduced fee schedule. And since my UCRs are between the 80-100th percentile for my area, it doesn’t hurt me financially to offer that sort of discount to patients who sign up for the program. QDP creates a win-win for the practice and keeps the third parties out of your office—or at least minimizes their impact.

If insurance companies update their fee schedules, then it is in dentists’ best interests to do the same. Keeping your fees in line with the local standards will keep your patients happy and your practice running most efficiently.

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