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On Delta Dental and the National Association of Dental Plans

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ADA News Tries Sarcasm

[By D. Kellus Pruitt DDS]

For fear of retaliation, ADA officials are reluctant to admit that Delta Dental and other members of the National Association of Dental Plans (NADP) have traditionally used the FTC as a tool to intimidate our professional organization. This means that for decades, the federal government has prevented the ADA from adequately representing the interests of dentist members. Something interesting happened in the ADA just days ago that is related to this tyranny. I assume frustration in the ADA’s unfair struggle against both Delta Dental and the FTC caused the editor of the ADA News to recently permit sarcasm for the first time in history – perhaps to attract attention to Delta’s policies?

A Humorous Article 

On August 9, ADA reporter Kelly Soderlund was given the green light to post an uncharacteristic, tongue-in-cheek introduction to her article, “Decision supports Massachusetts Dental Society insurance challenge.” http://www.ada.org/news/4558.aspx She sold it: “For nearly 40 years, Massachusetts dentists have had to abide by a regulatory order that allowed Delta Dental Plan of Massachusetts to receive an additional 5 percent discount off reimbursement fees in addition to other plan discounts.” Soderlund continues, “More than a decade ago, the Massachusetts Dental Society tried to get the order lifted but was unsuccessful. But now, after a reinstated five-year battle, the New England dentists can claim victory.”

OK. I lied.

In spite of her unintentionally humorous description of the Massachusetts Dental Society’s ineffectiveness, Soderlund was actually not sarcastic. That’s right. The ADA indeed hails this (very qualified) success as a long-fought glorious victory for dentists in Massachusetts where 95% of them are Delta preferred providers. That can’t be good for the health of Massachusetts dental patients. Managed care dentistry is dentistry by the lowest bidders with no quality control, and patients notice. Some stop going to the dentist, causing Delta Dental to reap even more profit. That is why it is not in Delta’s interest to satisfy their clients, and the employers who purchase Delta’s plans are clueless. This makes Delta Dental unaccountable to anyone.

The Delta Business Model 

Delta’s business model helps make the company one of the most unfair discount dentistry brokers in the nation, in my opinion. If you want proof, go to doctoroogle.com and visit any major city.

http://www.doctoroogle.com/dentist_ratings.cfm/pageID/2 Then compare dental patients’ ratings of Delta’s preferred providers to fee-for-service dentists’. In the numerous studies I’ve performed, Delta’s dentists’ average satisfaction level as determined by their patients is consistently inferior to fee-for-service dentists. (See Managed Care Report Card from November 10, 2008).

http://community.pennwelldentalgroup.com/forum/topics/transparency-and-managed-care?commentId=2013420%3AComment%3A19577

Delta Accountability? 

As you can see, since the FTC inhibits the ADA from honestly telling our story, dental care principals desperately need the ADA to open our Facebook so Delta can be held accountable to dentists and patients. Otherwise, Delta will never assume responsibility for the dental homes its preferred provider lists break apart – more often than not, sending their clients to less satisfying offices. What’s more, even Delta officials admit that “changing dentists causes fillings.” (See “Managed Care or Dental Homes – You can’t have both,” September 30, 2008)

http://community.pennwelldentalgroup.com/forum/topics/2013420:Topic:14014

FTC Fear 

If dentists and patients are not permitted to tell our story ourselves through the nationally recognized American Dental Association, we will always be 40 years behind Delta Dental and 5% short of what they owe us. Even though ADA leaders will forever be handicapped by fear of the FTC, individual Americans have nothing to fear. The failure of the Massachusetts Dental Association shows us that an ineffective ADA is worse than no ADA at all because a victory after 40 years is defeat.

MDA Victory 

One can read from Soderlund’s words that the Massachusetts Dental Association’s “victory” didn’t even slow Delta down. She writes “Delta Dental of Massachusetts has informed the ADA that the new reimbursement methodology will include the development of regional fee schedules. Information on exactly how those regional fee schedules will be developed and how that will affect dentists’ reimbursement has not yet been made available.” Whatever methodology Delta’s actuaries come up with, you can be sure it will be biased against their clients’ interests and will more than make up for the 5% of principals’ money that they conceded after 40 years. We simply must face the fact that the ADA isn’t helping. Soderlund continues: “The company also announced a new voluntary program to compensate dentists for successfully managing the care of higher risk patients. Delta Dental has not yet explained how that compensation would take effect.”

Assessment

Do you trust a Delta Dental consultant – who works on commission – to decide what is best for your patient? Or are you ready to demand that the ADA open our Facebook so we can all tell Delta Dental what we think of their unfair practices on an individual basis guaranteed by the First Amendment? Our patients depend on us to protect them from harm caused by greedy stakeholders. As Soderlund describes it, we’re losing, but not without humor.

Conclusion

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15 Responses

  1. Delta Dental

    I hold stakeholders accountable to my patients as sport. After all, it’s our turf – not theirs.

    I like to think that just like any other American dentist who strives to keep his or her community safe for patients, I have the power and indeed the obligation to hold Delta Dental accountable for promoting harmful business practices both inside and outside ADA Headquarters in Chicago. Since Delta is arguably the sleaziest discount dentistry broker in the nation, it simply fascinates me that I’m apparently the only dentist kicking their butt on the Internet. It’s weird. And it certainly gets me in trouble with humorless good ol’ boys in the ADA. But it’s also huge fun, actually. If one doesn’t count the Delta expatriates in official positions in the ADA, nobody defends the honor of Delta Dental – not even Delta’s top PR expert, Ari B. Adler from Michigan.

    Other than having been officially accused of “unprofessional conduct” by anonymous officers in the ADA, I never meet resistance from my criticism of dental care stakeholders like Delta Dental and anonymous officers in the ADA. And since I always work alone, I have a hands-down advantage over ADA officials. I can publicly criticize Delta Dental without ever getting into trouble with the FTC. On the other hand, the ADA’s fear of FTC problems – strategically inspired by Delta’s attorneys I hear – prevents the leaders in my profession from speaking honestly about Delta’s unfairness to their clients. That’s just not right. When the varmints cheat their customers, they harm clueless dental patients in our community, Doc. Those are the people who pay our bills and trust us to watch out for their interests according to the Hippocratic Oath.

    The instant dentists become ADA officials they forfeit power each individual member is otherwise guaranteed by the 1st Amendment. That’s a lot to ask an American to sacrifice for his or her profession. More than one of this year’s ADA President-elect candidates proudly calls it “speaking in one voice.” I call it a desperate gag rule meant to prop up failing bureaucracy. The shallow committee-approved talking point is no more clever than bald tyranny dressed up as a cheap buzzword with whiskers.

    There is naturally a fear of decentralization of power for those inside dinosaur bureaucracies and their co-dependants. Downsizing won’t be painless, but we have no choice. Moral rot has spread unchecked for decades within the ADA as well as Delta because of lack of personal accountability. One day, I may just have to write a book about how the Internet modernized the dental industry next year – including Delta Dental’s transparency in advertising.

    DrBicuspid Associate Editor Rabia Mughal interviewed Delta Dental’s PR expert Ari Adler for his January 30, 2009 article “Dentists or patients: Who should get the insurance check?” According to Mughal, Adler is reported to have said “direct reimbursement to out-of-network dentists is a problem because it allows them to enjoy the benefits provided by the network without following cost guidelines and quality control measures of the network.”

    http://www.drbicuspid.com/index.aspx?sec=sup&sub=pmt&pag=dis&ItemID=301436

    Even though it’s low-hanging fruit, let’s skip Adler’s Soviet-style statement that their contract dentists “enjoy” the benefits of being preferred providers. When Adler suggested that Delta imposes cost controls as well as quality controls, wouldn’t that put Delta’s preferred providers in what could only be the most totalitarian business 5 year plan since Mao Zedong’s “Great leap forward” of the early ‘60s?

    Think about it. If Delta requires unrealistic levels of quality while at the same time limits what the dentist can charge on the increasingly time consuming INTRICATE procedures covered by Delta, who will suffer when corners are cut to pay the increase in rent? Delta? Of course not. Delta is making the rules. The dentist? … Up to a certain point, ethical dentists will lose money to provide their patients the best possible care. But ethical dentists cannot stay in business without profit.

    Here’s some news: Ethics ain’t free.

    Ultimately, in Delta’s triangle of irresponsibility, it’s the Delta clients who are always uninformed and vulnerable. Delta clients will always be harmed when Delta executives squeeze providers for more profit, bigger bonuses and even more power. As anyone can see, Delta Dental is a cruel and unethical monster even before their recent push to limit fees dentists can charge on procedures not even covered by their plans. That’s beyond moral rot. That’s tyranny.

    I asked Mr. Adler about Delta’s ethics numerous times over the last 18 months starting with comments following Mughal’s article. My criticism of Delta is one of the reasons DrBicuspid’s editor Kathy Kincade kicked me off the Website. The other reason was a pending advertising deal between DrBicuspid and the ADA. The day after I was gone, the ADA welcomed DrBicuspid as a preferred ADA vendor. Probably a coincidence.

    Adler had even more careless promises to offer DrBicuspid readers: “We put our dentists thorough a credentialing process and provide quality assurance. That means if a dentist does a filling that should last a certain amount of time and it doesn’t, they have to fix it without charging the network or the patients.”

    Since reading Adler’s incredible guarantee, I’ve tried many times to coax the man out into the open to further explain the selling point. Two days ago, Adler, who is very active on Twitter with 4000 followers (to my 200), gave a generous tribute to Delta Dental (his boss) for philanthropy even as Delta’s unfair business practices cheat their clients. I told Adler that I think that’s dishonest.

    Regardless, he still hasn’t responded.

    ——–

    Delta’s PR expert @aribadler said, “I’m pleased to announce Delta Dental has won an award for its philanthropy! http://pitch.pe/85329

    Delta Dental is a sleazy discount dentistry broker that is attempting to unfairly limit fees on preferred providers’ non-covered procedures.

    Hey, @aribadler. Al Capone was charitable, but he was still a crook.

    Who are you trying to impress? Politicians?

    Did you know that I invited Delta CEO Kim Volk to be my Facebook Friend and she has ignored my invitation for over a year?

    In fact, I went on Delta’s “Advance Oral Health” Facebook and asked Ms. Volk several questions, yet she continues to ignore this dentist.

    Link: http://www.facebook.com/posted.php?id=116240205341#!/pages/Advance-Oral-Health/116240205341

    No, @aribadler, I’m hardly impressed with your boss. I think Delta Dental represents everything that is bad about dentistry.

    Proots

    Like

  2. I just love providing post-graduate training in modern public relations

    ——————————————————————————–

    From: pruittdarrell [mailto:pruittdarrell@sbcglobal.net]
    Sent: Friday, October 01, 2010 12:50 PM
    To: ‘alew@delta.org’
    Subject: The business end of transparency

    Dear Adrienne Lew – Community Contact for Delta Dental:

    I both read and listened to your interview on WCPN 90.3 FM concerning your employer, Delta Dental.

    http://www.wcpn.org/WCPN/news/32256

    Since I’m a dentist, it is in my patients’ interest to watch Delta closely, and I’m an Internet veteran. Excuse me if I’m wrong, but I must assume you are the newest apologist on Delta’s PR team – putting in your time on the front lines. From the sound of your voice, I’d guess that you are in your early to mid 20s – perhaps a recent graduate with an inadequate degree in public relations. Or maybe, only months ago, you were doing something entirely different for Delta and suddenly you’re doing two or more peoples’ jobs for the same amount of pay. That’s happening a lot. Either way, let me give you your first lesson in unconventional PR tools.

    I can tell that you are new to the frontier because not only are you not on Facebook, but even with your unique name, you don’t have much of an Internet presence at all. Come to think of it, I haven’t seen Ari Adler or Janis Oshensky out in the wide open in a year or so. I miss them. I wonder if they moved on to other things.

    A few months ago, before I was kicked off of Pruitt’s Platform for being an effective “bully,” I had accumulated enough SEO (Search Engine Optimization) power to overwhelm not only Oshensky’s first search page with my opinions like the one for you below, but I owned 8 of Delta CEO Kim E. Volk’s first 10 hits. As a matter of fact, I bet if you google “Kim E. Volk” today, at least one of my comments will appear on her first page.

    If I had only met you earlier, Adrienne, I could have really boosted your SEO power by simply coupling your name to mine on Pruitt’s Platform. Oh how those were the days.

    I found what you told WCPN to be an interesting spin on bad times for Delta Dental. I’ve posted my opinion of your remarks on a couple of venues. Feel free to respond by email or Facebook. As you can read in my comment, I’ll happily invite you to be my Facebook friend when you decide to join the community you serve.

    It’s only because you work for Delta Dental that I’d like to get to know you better. I don’t have anything to hide from you, and I’d like to know who your friends are as well as to keep an eye on other things you have to say about Delta Dental. Adler once said that Delta Dental guarantees the work of its preferred providers. I’ve asked him to explain more about that claim many times, but he has never responded. I hear he teaches public relations as an adjunct professor at Michigan State. That makes sense.

    It’s for those kinds of reasons that I intend to do what I can to prevent naïve dental patients from being misled by PR staff like you. It’s not at all personal, Adrienne. It’s Hippocratic.

    Darrell

    ———-

    Adrienne Lew, the Delta Dental representative who was interviewed by Gretchen Cuda for her piece about dental insurance, revealed what I have to assume is Delta Dental’s new, more realistic sales strategy for tough economic times: Don’t blame Delta for their cheap, lousy product – blame employers for not diverting enough employees’ compensation for a more expensive lousy product.

    So what’s next? At some point, employers are going to say, “If this is all my employees get in return for the money we send Delta, why even bother with Delta’s preferred provider lists and other disappointments? Why not just give the money to the employees instead?”

    From the appearance of desperation in the dental benefits market, I think that point has already come. The least dentist-friendly of the benefits companies, Delta Dental, is justifiably struggling the most. Delta has treated both clients and dentists so horribly for decades that they have no friends any where. Yet the leadership of the discount dentistry broker still refuses to discuss Delta’s policies with the dentists whom their rules affect.

    I’ve invited Delta CEO Kim E. Volk to be my Facebook friend many times. She never responded to me. I ask you, what could be her reason for ignoring a dentist other than her intention to avoid personal accountability?

    I wonder if Adrienne Lew has a Facebook. I’d like to ask him questions about Delta’s intention to limit fees on procedures Delta doesn’t even cover.

    Darrell K. Pruitt DDS

    Like

  3. Delta Dental and self-promotion

    I follow @DeltaDental and other discount dentistry brokers on Twitter. Sometimes Delta’s PR crew tries the cutest things:

    @Delta Dental tweeted: “Looking at a news release: http://www.businesswire.com/news/home/20110107005875/en/Delta-Dental-Recognized-2011-Places-Work-Virginia

    Here is the introduction to the press release purchased by Delta Dental (no byline). “ROANOKE, Va.–(BUSINESS WIRE)–Delta Dental of Virginia was recently named to the inaugural list of the 2011 Best Places to Work in Virginia. The award was developed through a unique partnership between the Virginia Chamber of Commerce, Virginia Business magazine, the Virginia Society for Human Resource Management and the Best Companies Group.”

    And that prompted me to dedicate today’s Twitterpoem to my 2 year old question to Delta Dental:

    @DeltaDental, You may be one of the 2011 Best Places to Work in Virginia, but as a dentist who has to put up with your crap… you stink.

    @DeltaDental of Michigan once had a public relations specialist named Ari Adler who said that Delta’s preferred providers’ work is guaranteed.

    It was in a DrBicuspid article posted on Jan 30, 2009, titled, “Dentists or patients: Who should get the insurance check?”

    Link: http://www.drbicuspid.com/index.aspx?d=1&sec=sup&sub=pmt&pag=dis&ItemID=301436

    “We put our dentists thorough a credentialing process and provide quality assurance,” Ari Adler said. Now he has a government job.

    Speaking for Delta, Adler continues “That means if a dentist does a filling that should last a certain amount of time and it doesn’t,…

    “… they have to fix it without charging the network or the patients.” @DeltaDental (a swell place to work), what did Ari Adler mean?

    I’ve tried numerous times to get @DeltaDental to explain how the guarantee works, but neither Adler nor Delta of Michigan will respond.

    Last I heard, Adler found himself a job in the Michigan State Capitol. Figures.

    Proots

    Like

  4. The Texas Legislature passed a bill that prevents Delta Dental from capping fees for dentists’ services the company’s unethical policies don’t even cover. It’s a sign of the times when Delta’s unfair business practices require state governments to kill. A small, but important victory against tyranny.

    http://e-lobbyist.com/gaits/text/303191

    Darrell

    Like

  5. Holding Delta Dental of Illinois Accountable

    Yesterday, “State’s new dental plan cuts fees for member dentists” by Dean Olsen was posted on rrstar.com, based in Rockford, Illinois. It’s easy to see that Delta Dental will continue to use its sleazy, unfair business tricks until someone stands up against them. Stay seated, sports fans. I’m all over it.

    http://www.rrstar.com/news/x1158634424/States-new-dental-plan-cuts-fees-for-member-dentists

    Here is my comment that the Rockford Register Star doesn’t seem to want its readers to see. Who cares if they post it or not. I’ll get the message out:

    If I don’t call attention to how Delta Dental deceives Illinois’ state, county and municipal employees, who will? ADA Headquarters in Chicago?… Yea, right. Everyone in dentistry knows that salaried ADA officials have always shown bias in favor of Delta because of their employment exchange program. Naturally, the revolving door makes ADA officials unlikely to criticize their potential boss, and Delta Dental leaders like CEO Bernie Glossy are naturally unlikely to listen to caring dentists whose clueless patients Delta stealthily cheats.

    “Scheff said dentists don’t have any more reason to request upfront payments now, as long as they trust their patients to pay their bills.” Hank Sheff, the director of employee benefits for Chicago-based Council 31 of the American Federation of State, County and Municipal Employees, is either clueless or deceitful. It smells like deceit to me, Hank. Shouldn’t you be more honest with the union members who pay your salary?

    Everyone knows that there is not a business in the world that can risk giving clients the option of reaping unearned profits in addition to receiving free services. Hank Scheff is obviously proud of the deceptive deal some bonehead union official made with Delta Dental. The union employee clearly favors Delta’s profits over union members’ interests. Why else would Hank insult every dentist in Illinois?

    By the way, union members. There is good reason dentists nationwide have always hated Delta Dental and chief executives like Bernie Glossy: Delta isn’t insurance. It’s a sleazy, unresponsive discount dentistry broker with no quality control. It only takes a few minutes of research of dentists’ ratings on doctoroogle.com for Chicago for one to confirm that Delta’s preferred providers are only preferred by Hank and Bernie – and neither can be held personally accountable for misleading those who pay their salaries… not yet.

    D. Kellus Pruitt DDS

    Like

  6. I’ve been kicked off another Facebook

    In a heroic effort to shield Illinois State Dental Society members from truth and ADA officials from accountability, an anonymous ISDS Facebook moderator kicked me off of their Facebook today without warning or explanation.

    https://www.facebook.com/pages/Illinois-State-Dental-Society/119960583562?sk=wall

    So do you think this shameful development in my dental career will embarrass my family while waiting in line in Wal-Mart?

    I posted a challenging but fair opinion concerning Dean Olsen’s rrstar.com article, “State’s new dental plan cuts fees for member dentists,” on a half-dozen venues this afternoon – including the Illinois State Dental Society Facebook which I discovered had shared the link to the same article.

    http://www.rrstar.com/news/x1158634424/States-new-dental-plan-cuts-fees-for-member-dentists

    I must have really pissed off a very important (but anonymous) ISDSofficial who obviously doesn’t yet understand the nature of transparency on social networks… What do you want to bet she’ll catch on soon.

    The moderator, who customers cannot hold personally accountable, not only censored my comment from the ISDS Facebook, but she even deleted the link to the rrstar.com article – depriving ISDS members of information that some official suddenly determined was less important for dentists than preserving ISDS’s carefully manicured facade of professionalism.

    If I were still able to comment directly to ISDS officials on an ISDS venue – instead of counting on incidental angry ISDS members to relay my concern about conflicting interests – I would congratulate the authorities for having the (oblivious) courage to attempt to shield their 518 fans from reading what was posted on numerous venues, including the Medical Executive-Post (with over 300,000 readers). Feeling a bit silly, ISDS?

    https://medicalexecutivepost.com/2010/08/19/on-delta-dental-and-the-national-association-of-dental-plans/#comment-10231

    Why are you protecting Delta Dental of Illinois and the American Dental Association from scrutiny, ISDS officials? What are YOU hiding from your members?

    D. Kellus Pruitt DDS

    Like

  7. As a business, Delta Dental has no heart. How could it? Delta sells discounts

    Shy good ol’ boys who are accustomed to insulated 1950s businesses models are confounded by internet openness. That is why Delta Dental, a discount dentistry broker with no quality control, is running out of places on the internet to shop their defenseless products that were developed in a more protected environment.

    What’s more, if Delta officials couldn’t buy friends, they’d have no friends at all. Remember Delta’s million dollar donations that were hyped in dozens of their recent press releases – including the ADA News’? It’s becoming clear to me that the donations are strategic distractions from much bigger transparency problems facing the insensitive Michigan company.

    For example: Late last night, Laura Misjak, writing for LansingStateJournal.com posted “Okemos-based Delta Dental’s celebration picketed by recent retirees – Former employees say health benefits unfairly cut off.”

    http://www.lansingstatejournal.com/article/20110827/BUSINESS/108270311/Okemos-based-Delta-Dental-s-celebration-picketed-by-recent-retirees?

    “The retirees, all women, said Delta Dental unfairly cut off their coverage this spring, ’Some of us would not have even retired if we knew this would happen,’ said Jackie Lacey, who held a sign that said ‘No loyalty to retirees.’” Imagine that, sports fans.

    So if secretive Delta Dental arguably cheats clients, dentists, and now even its own employees, doesn’t that mean the monster is no longer accountable to anyone in the nation, and actually a menace to society? American dental patients are fortunate that the Federal Trade Commission protects them from insurance deceit.

    … Not so fast. An archaic, insurance-friendly law called the 1945 McCarran-Ferguson Act shields Delta Dental and other National Association of Dental Plan (NADP) members from federal anti-trust investigations. That’s right. Because of the 1945 M-F Law, not even the FTC can punish Delta’s officials for unfair business practices agreed to by NADP members. Without federal help, Delta Dental’s morally bankrupt business plan would have never survived marketplace competition this long.

    Discount wars

    Even before Delta’s betrayed employees staged their protest at the unveiling of Delta’s new newly finished $91 million expansion and renovation of the Delta Dental headquarters in Okemos, the company was already hurting. Recently, newcomer Brighter.com started advertising 60% discounts for their dentistry compared to Delta Dental’s newly uncompetitive 30% discounts. Watch for Delta veterans to respond by selling more discount and less quality, as well as cutting more employee benefits.

    D. Kellus Pruitt DDS

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  8. Is Dental Insurance Worth It? 5 Ways to Save on Care

    Dental coverage is usually separate from health insurance, and your employer may not offer it. If that’s the case, is it worth getting? At least one dentist says no.

    http://www.moneytalksnews.com/2011/07/29/is-dental-insurance-worth-it-5-ways-to-save-on-care/

    Mary

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  9. More on Deltal Dental

    Will Delta Dental’s new Vice President, Dr. William Kohn, be transparent about Delta’s quality control measures? Or has the former CDC official already gone over to the dark side? Let’s find out.

    I posted this message to my acquaintance following an article on LifeHealthPro.com where he was staking out Delta Dental’s turf in Obamacare, should it ever arrive.

    http://www.lifehealthpro.com/2011/11/19/ppaca-dental-plans-weigh-in-on-essental-benefits

    ———————

    Dear Dr. William Kohn, Delta Dental Vice President

    I don’t know if you remember me, but you and I met during a break at the ADA’s 2008 Annual Dental Benefits Conference in ADA Headquarters when you were still with the CDC. Following the break, Shawna Mercer, a CDC colleague, presented the final lecture of the conference titled “The Guide to Community Preventive Services: Developing EB [Evidence Based] Recommendations for Promoting Oral Health and Cultivating their Dissemination.”

    She assured the audience of around 100 that it is the mission of the CDC to promote safe and effective dental care for the nation based on the best evidence available. She urged us to “Stay true to the evidence,” and followed the advice with the rhetorical question, “How do you improve the oral health of the entire population?” I quickly recognized the question to ask during the next discussion period: “If the CDC discovered that managed care dentistry is inferior to freedom of choice dentistry, would you say anything about it?”

    If you recall, Dr. Kohn, Ms. Mercer actually wanted no part of a taboo discussion questioning managed care quality, and immediately called out to the audience, “Bill, do you have a response for this question?” You responded, “No, I don’t have any information about such a study, but it sounds interesting to me.” But when you returned to the CDC, I assume you never actually considered such a study, did you. Three years later, you are now an employee of Delta Dental.

    According to the opening paragraph of Allison Bell’s article “PPACA: Dental Plans Weigh in on Essential Benefits,” in your testimony to HHS, you pleaded with designers of the new Essential Health Benefits (EHB) package to make sure that consumers have the ability to compare dental plans and buy dental coverage separately from medical coverage.

    Only days ago, you said, “Without this transparency consumers will not be able to see what they are truly paying for their dental benefit within the medical plan. A level playing field needs to be maintained to allow consumers to continue the ability they currently have in the private market today that allows them to compare, cost, and choose the oral health care that will most effectively meet their needs.” No mention of quality?

    As I understand your dilemma, Delta leaders fear that if dental insurance for children is included in Obamacare medical packages, parents likely won’t bother to purchase free-standing dental plans like Delta’s just to cover their own dental needs. Many who are already painfully aware of Delta’s poor quality control will choose instead to keep their teeth especially clean and to pay a free market price for dentistry from a dentist of their choice as needed – eliminating Delta Dental premiums entirely while also enjoying better oral health. In addition, by paying fees that are fair for everyone, former Delta clients are more likely to receive better care. After all, ethics aren’t free, you know.

    I agree with your 2008 ideals, Dr. Kohn. Consumers deserve more transparency from Delta Dental concerning dental coverage. I hope you will be transparent with us concerning Delta’s advertised quality control measures.

    A few months following the Dental Benefits Conference, DrBicuspid.com Associate Editor Rabia Mughal interviewed Delta Dental’s PR expert Ari Adler for his January 30, 2009 article “Dentists or patients: Who should get the insurance check?”

    http://www.drbicuspid.com/index.aspx?sec=sup&sub=pmt&pag=dis&ItemID=301436

    Adler says “Direct reimbursement to out-of-network dentists is a problem because it allows them to enjoy the benefits provided by the network without following cost guidelines and quality control measures of the network.” What quality control measures was the Delta employee referring to, Dr. Kohn?

    Adler added: “We put our dentists thorough a credentialing process and provide quality assurance. That means if a dentist does a filling that should last a certain amount of time and it doesn’t, they have to fix it without charging the network or the patients.”

    In the three years since reading about Delta’s guarantee, I’ve repeatedly asked Delta officials like you to clarify Mr. Adler’s promise of quality which attracted naïve and vulnerable Americans to purchase Delta’s discount dentistry – thinking Delta officials were watching out for their welfare. Nobody from Delta ever responds.

    More recently, in August of this year, Delta Dental posted a press release which says that your dental HMO plan relies on a “carefully selected network of more than 16,000 dental facilities nationwide.”

    http://www.deltadentalins.com/about/pressroom/2011/delta-dental-rolls-out-enhancements-in-four-states.html

    Can you share with us the criteria on which these dental facilities were selected? How often does Delta inspect the facilities? Once a year? Never?

    Later in the same ad, Delta promises: “In addition, all DeltaCare USA dentists undergo a comprehensive credentialing process to ensure they meet Delta Dental’s quality standards.” Again, since you advertised the credentialing process to attract customers, could you please share the details of your quality standards?

    Coming from the CDC, you know in your heart that Delta Dental must become more transparent with the dental community, Dr. Kohn. As Shawna Mercer says, we must “stay true to the evidence.”

    Sincerely,

    D. Kellus Pruitt DDS

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  10. An invitation to Dr. Kohn

    Dear Dr. William Kohn, DDPA Vice President:

    Within the last three months, A. M. Best has downgraded issuer credit ratings of three Delta Dental Plans Association (DDPA) member organizations: Delta Dental of Wisconsin, Minnesota and Nebraska. I think that is the reason why Delta Dental officials who refuse to discuss their plans with dentists are trying to rent friends wherever they can.

    Since Thursday, Delta has purchased at least 6 press releases proudly advertising their re-gift of $350,000 worth of clients’ premiums to the University of Texas Dental School at Houston as the largest donation in the school’s history.

    Will you ever again be permitted to freely talk to dentists, Bill?

    D. Kellus Pruitt DDS

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  11. Delta Dental ran out of luck in Rhode Island

    The Providence Journal posted an article yesterday titled, “BREAKING NEWS: Delta Dental fined $25,000, ordered to make improvements,” by Felice Freyer

    http://news.providencejournal.com/breaking-news/2012/01/delta-dental-fi.html

    “Health Insurance Commissioner Christopher F. Koller ordered Delta Dental to adopt their recommendations to improve complaint processing, quality monitoring and appeals of payment denials.”

    I shared the link on Delta Dental Insurance Company Facebook along with the suggestion, “Perhaps you should start listening to complaints from dentists and patients, Delta.”

    https://www.facebook.com/deltadentalins?sk=wall

    Then I posted a survey on a couple of Facebooks: What will Delta officials do with my suggestion?

    A. Ignore it

    B. Censor it

    C. Thank me for bringing it to their attention

    So far, nobody has responded.

    Today, Richard Asinof revealed the commissioner’s recommendations for change in Delta Dental policies in his article “Delta Dental fined $25K for claims’ process,” posted on Providence Business News.

    http://www.pbn.com/Delta-Dental-fined-25000-for-claims-process,64828

    – Delta Dental should institute processes to record and act on all complaints, whether written or verbal.

    – Delta Dental should discontinue use of the utilization management program as its primary mechanism to address poor quality care. A quality management program should incorporate a process to address substandard care to protect members from providers that insurer has identified as providing poor quality care.

    – Delta Dental should institute a study of its claims denials to determine the reasons for the high rate of overturn on appeal.

    Delta responded: “We strive to minimize dissatisfaction and to respond appropriately to complaints, but we can always learn from our mistakes and work to improve our performance.”

    Let me help you with that, Delta: It looks to me like you should start spending more money on dentists and less on press releases highlighting your re-gifting of dentalcare dollars as donations to charitable causes. I warned you about your lack of quality control long ago, but you refused to respond to this dentist. That’s unfortunate.

    Rhode Island is only one small state. Now I’d like to see the other 49 kick Delta’s butt. Please share this with your friends: What’s good for our patients is good for us, Doc.

    D. Kellus Pruitt DDS

    Like

  12. Who will defend Delta Dental?

    Can anyone defend Delta Dental’s rudeness – the largest and cheapest discount dentistry broker in the nation? Before stepping forward, please witness how casually one of its bonehead CEOs named James Dwyer infuriates the dentists WDS clients are limited to choosing from for care.

    This week, KING 5 News in Seattle featured, “Executive pay soars as one of WA state’s largest non-profits makes cuts” – an investigative report about Delta Dental affiliate, Washington Dental Service, written by Chris Ingalls.

    http://www.nwcn.com/home/?fId=150968095&fPath=/news/local&fDomain=10212

    According to Ingalls, WDS CEO James Dwyer earned $1.2 million in 2010 – topping off a 45 percent pay increase he has enjoyed for the previous 5 years…. Even as he made across-the-board 15 percent cuts to the fees Delta Dental pays their clients’ dentists in Washington. “WDS said the cuts allowed it to reduce the premiums it charges employers for dental insurance, a move that makes its service more competitive in the marketplace.”

    When asked how paying less for Delta clients’ dental care affects their dentists, CEO James Dwyer, who earned $1.2 million in 2010, responded: “They’ve lived in a wonderful, insulated world. God love ‘em. But it’s changing.” Then, just to aggravate me even more, CEO James Dwyer (remember that name) suggested, “Number one, they could start by working 5 days a week.” That dude is a sweetheart, isn’t he, Doc?

    James Dwyer is a CEO who takes $1.2 million healthcare dollars from clueless Americans by selling rushed dentistry at discounted fees with no quality control. He is just one more millionaire Delta official who cannot be held accountable to the dental patients they harm. And after cutting payments to his clients’ dentists, James Dwyer has the nerve to suggest that they start working even harder for him. Meanwhile, the market-dominating non-profit escapes taxes its for-profit competitors can’t.

    Seattle dentist Dr. Chris Pickel reveals what I have warned for years: “It’s the patient that loses.” He adds, “We’ve basically had to figure a way we can compress patient time.” He says, “It’s something we don’t like to do. We want to spend time with people. We like to spend time educating them.” Dr. Pickel didn’t mention that dentistry is also intricate handwork performed in sensitive mouths to exacting tolerances. As anyone can imagine, dentistry cannot be rushed without painful consequences… but rushed it is by Delta Dental’s unsustainable fee schedule. Ethics aren’t free.

    Dentistry unhurried is the kind of dental care both patients and dentists prefer.

    If strong, well-supported opinions I’ve posted describing the harm Delta Dental’s unfair pricing causes naïve dental patients were inaccurate, don’t you think someone would have defended Delta by now? The complete absence of (public) responses to my criticism tells me that oblivious Delta officials like Million-dollar Dwyer long ago lost America’s respect (they just don’t know it).

    D. Kellus Pruitt DDS

    Like

  13. Dental Coverage and Health Issues

    New research suggests having access to dental benefits leads to higher employee well-being. Employees with dental coverage visit the dentist more often than those without coverage. Americans who have dental benfits are more likely to say their well-being is better compared to those without dental coverage. A Delta Dental survey obtained the information from 1,003 adults.

    Dental Coverage (% of americans who visit the dentist at least annually)

    •78% – People with dental coverage
    •52% – People without dental coverage

    Health Issues

    •16% – of Americans say they have missed work due to oral health issues beyond regular treatments.
    •27% – of Americans say that they have unresolved oral health issues that they’d like to resolve.
    •21% – of Americans say they’ve been advised that they have gum disease.

    Source: Delta Dental Oral Health and Well-Being Survey, 2014

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  14. Thanks, Ann

    You got my attention. Let’s hope someone from Delta Dental responds.

    Purchasing cheap dentistry from Delta Dental’s preferred providers that a patient knows nothing about is not as simple as choosing the lowest priced can of beans at Wal-Mart. The anonymous Delta Dental employee who posted the misleading advertisement describing utilization of dental benefits cannot be held accountable for the underfunded dental work Delta sells to uninformed Americans. Neither can Delta.

    It is not surprising that those who have dental benefits are more likely to visit the dentist. By the way, counter to what Delta Dental Insurance Company would lead trusting individuals to believe, there is no such thing as “dental insurance.” In spite of its name, Delta Dental is nothing more than a dentistry broker who sells discounted dental work with no quality control to vulnerable, naive Americans with ads like this one.

    It is truly unfortunate that Americans are so easily misled by bargains that are too good to be true. For example, Delta advertises discounts of over 30% of dentists’ fees, yet overhead in dental practices runs approximately 30%. This means that unless Delta Dental preferred providers cut corners, they lose money with every patient who walks in the door. It’s a simple, undeniable law of economics: You get what you pay for, even in dentalcare. Preferred providers’ profit margins are too narrow for generosity and as a result, Delta’s clients are more likely to endure painful dentistry performed much to quickly using inferior materials than patients who pay full price. That’s the hidden cost of discounted intricate handwork performed in one’s mouth.

    As for quality control, Delta Dental customers have no freedom of choice in dentists, and Delta’s preferred providers receive a steady stream regardless how they treat patients. On the other hand, dentists who must earn their referrals from satisfied patients cannot afford to over-charge or otherwise treat them badly.

    One should seriously consider the risks before purchasing discounted dentistry from a broker who refuses to acknowledge the importance of quality control.

    D. Kellus Pruitt DDS

    Like

  15. Delta Dental ?

    Dentistry by the lowest bidders with no quality control.

    “Lawsuit accuses Delta Dental of ignoring dentists’ concerns – A group of dentists in Washington state is suing the nation’s biggest dental insurer saying the company is compromising patient
    care.”

    Who didn’t see this coming?

    https://www.king5.com/article/news/health/healthcare/lawsuit-accuses-delta-dental-of-ignoring-dentists-concerns/281-d7695673-1bdc-423f-8ae2-66f73c7e683a

    D. Kellus Pruitt DDS

    Like

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