Finances


IF YOU THINK THE TREATMENT YOU NEED AND THE TREATMENT YOUR DENTAL BENEFITS WILL PAY FOR ARE THE SAME THINGS, THINK AGAIN. THEY ARE BY NO MEANS NECESSARILY THE SAME!

This office does not participate in dental managed care plans such as dental health maintenance organizations (DMO’s, also known as capitation programs). To explain why, let us help you understand how these plans work. After signing a managed care contract, the dentist is required to deliver care according to the terms of the plan. Under this arrangement, the dentist is reimbursed for each patient who signs up for dental care at his or her office from the plan's list. This is how a capitation plan works. It does not matter whether these patients visit the doctor's office or not in given year, only that they are enrolled there. Managed care plan standards have nothing to do with the time the doctor spends with each patient or the quality of care he or she provides. They only depend on the number of patients the dentist can possibly manage (there's that word again!) to see. This places the emphasis on the volume, not the quality, of care.
When these patients do need care, the doctor is often severely overworked by the sheer number of patients he or she is obligated to see by the regulations of the contract. This is how corners are cut and mistakes are made! If the dentist should refer patients to the care of a specialist, he or she will often lose their enrollment under the terms of the contract. What kind of dental care do you think you would receive under these circumstances? The answer is minimal at best with a specialty referral being rarer than snow in July. Some such contracts contain clauses (called "gag rules") that prohibit the doctor from discussing treatments that do require a specialist's expertise. This would be just fine as long as you want your dentist to ignore any problems you may have that aren't gagged by your plan, but then your dentist is working for the managed care company and not for you!

Managed care companies recruit dentists into their plans declaring that patients with this coverage will refer others into their practices who receive care using the doctor's established approach. This is usually not true because most patients refer family members and co-workers who are in the same plan. Even if it were true, it would make those patients covered by the DMO second class citizens to those patients in the dentist's practice who are proceeding with treatment according to the doctor's fundamental principles. The quality of dental care provided is inevitably comprised under this managed care scheme. In fact, many consumer groups have taken to using the term "mangled care" when referring to these types of plans.

Dr. Roden is only interested in providing the absolute best quality of care that he possibly can. For this reason and the state of affairs recounted above, it is in your best interest that Dr. Roden does not participate with any DMOs.

Earl N.Roden, DDS

Cosmetic & Implant Denstistry

847-945-1100

www.deerfieldsmiles.com 

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