Why We Are Not Preferred Providers

You may not be aware that the term ‘Preferred Provider’ is an invention of the Health Insurance Industry. The term ‘preferred’ has no relationship to the quality of care you will receive. Preferred Provider Schemes are designed to shape consumer behaviour for the benefit of the Corporations bottom line.

We at Your New Dentist are proudly independent. To ensure that you receive personalised, independent care and advice, Your New Dentist has not entered into any contractual arrangements with any Health Funds – we are not preferred providers in the dental industry.

At Your New Dentist we value our relationships with our patients. We are busy because of the service that we provide. Which is a result of not being a preferred provider of an insurance company.

Our industry code of ethics states; “Dentistry is an ethical profession and practising dentists are expected to place the welfare of their patients before any other consideration.”

By becoming a Preferred Provider we would be forced to function on a much lower dollar amount and compromises would have to be made. These compromises might include quality of staff, lower wages, quality of materials, and less funds for staff training and development.

As a result of becoming a preferred provider we would be limited in our ability to provide the sort of service that we love to provide to you. For our industry, the effect of increased private health fund control is eroding the freedoms of choice that dentists would normally have in the way they provide their services.

At Your New Dentist, we pride ourselves on providing high quality personalised care and treatment options that are in your best interests and long term health outcomes.

We are committed to contributing a percentage of all profits back to the local Community through charitable donations and sponsorships – something far more difficult to do as a preferred provider.

Your New Dentist is committed
to making a difference in the world
through the care of others

At Your New Dentist we believe that our view of truly personalised health care is incompatible with the preferred provider schemes.

The Australian Dental Association (ADA) also shares our concerns. Dr Terry Pitsikas AM, chair of the ADA’s Schedule and Third Party Committee, says that although preferred provider agreements have been around for probably more than two decades, it has only been in the past 10 years that private health insurance providers have begun aggressively targeting an increase in the numbers of contracted dentists.

More recently, we have also seen health funds actually owning dental surgeries and this, Dr Pitsikas believes, introduces serious ethical issues.

“One of the problems we have philosophically is whether a health insurer should actually be providing the service for which they are charging a fee, providing a rebate and then charging the contributor a fee to actually join the insurer,” he says, describing a clear conflict of interest that is not visible to the patient.”

A more extreme example, he says, “Is a bookie at a race course who also owns the race course itself and all of the horses, trainers and jockeys. Then add in the fact that they charge people to come and watch and then are instructing the jockeys in how they must ride their horse during each race.” says Dr Pitsikas.

It is not a pretty picture that experts draw of dentistry becoming the plaything of the health insurance industry, whose collective profits in general treatments alone (previously known as ‘ancillary cover’) over the past five years, according to an ADA report, have exceeded $5 billion.

“We field a lot of complaints from members on the basis that health funds are deliberately redirecting patients,” Dr Pitsikas says. “Patients who have had their usual dentist for the last 20 years are being forced by their private health insurer, by their punitive difference and discrimination in rebates between individual dentists, to go to a new dentist they have never met. Just by walking through the new dentist’s door they automatically receive a much higher rebate because this dentist has signed a contract with the health fund. If they elect to remain with their customary dentist, they are not offered reduced premiums because they will receive less rebate. Something just doesn’t add up here.” © BITE MAGAZINE 2015