Ep 47: The True Cost of Dental Insurance and Why It's Time for Reform

Straight Up With Steph

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Did you know that dental reimbursement rates and deductibles have not increased since the 70s? It’s no wonder that dental insurance is such a loaded topic in our profession. In this episode of Straight Up With Steph, I am joined by my friend and fellow dental hygienist, Bethany Montoya, to unpack the complexities and confusion surrounding dental insurance.

In our conversation, Bethany and I dive into the complicated history behind dental insurance, clarifying what it was originally designed for versus how it operates today. Bethany explains why it is crucial to make the distinction between “dental insurance” and “dental benefits,” why the term “insurance” is misleading, and what common misconceptions patients bring into the operatory. We also discuss effective ways to talk with patients about why certain necessary treatments may not be covered, how benefit plans truly work, and why offices are being forced to choose between participating with insurance companies and delivering high-quality, value-based care.

Bethany shares practical steps for practices considering a transition away from low-reimbursement plans, and we talk candidly about the cascade of effects—like increased workload, burnout, and stagnating wages—that hit both teams and patients.

The hard truth is that the system as it stands is unsustainable, and it’s on us—as clinicians, practice owners, and patient advocates—to drive change, educate our communities, and stand up for the quality care our patients deserve.

About Bethany:
Bethany Montoya is a practicing dental hygienist, educator, author, editorial director of DentistryIQ's Clinical Insights newsletter, and key opinion leader. Her social media brand, @humanrdh, speaks to the human aspect of working in dentistry and highlights the vital role hygienists play in our healthcare system.

Connect with Bethany:

[email protected]

HumanRDH [Instagram]

HumanRDH [Facebook]

Human RDH [TikTok]

LinkedIn

Texas Dental Hygiene Alliance [Facebook]

Texas Dental Hygiene Alliance [Instagram]
To watch on YouTube, click here!

Disclaimer: The opinions expressed by guests on this podcast are their own and do not necessarily reflect the views of Polished Posture. The information shared in this podcast is for educational and entertainment purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for any health concerns or before making significant lifestyle changes.

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Chapters

1. Introduction of Bethany Montoya (00:00:00)

2. How Dental Insurance Started (00:04:12)

3. Why Dental Insurance Isn’t Actually Insurance (00:06:24)

4. Common Misconceptions About Dental Insurance (00:08:12)

5. Talking to Patients When Procedures Aren’t Covered (00:11:06)

6. Critically Low Dental Insurance Reimbursement Rates (00:14:19)

7. Advice for Practices Considering Dropping Insurance or Going Fee for Service (00:22:22)

8. How Insurance Controls Fees (00:26:03)

9. How Insurance Reimbursement Affects Practice’s Ability to Pay Employees (00:34:08)

10. Is Allowing Assistants to do Hygiene a Solution to Insurance Reimbursements (00:37:22)

11. How We Can Be Part of the Solution for Insurance Reform (00:45:37)

12. How to Connect with Bethany Montoyta (00:49:53)