When you became a participating dentist with WDS, you signed a contract. That contract is between you, personally, and WDS, the corporation. WSDA has no standing in that contract. We cannot interfere with a contract to which we are not a party.
April 11, 2011
In addition, because this is a fee issue, we are not permitted by the anti-trust laws to represent our members. The law views each of your practices the same way it views General Motors. Under the law, no two businesses can conspire to set or control fees. WSDA represents over 2,500 different businesses. We are not a union and, therefore, not exempt from the law.
The law does permit us to take action by appealing to government agencies which we did successfully last year by preventing insurance companies from controlling non-covered benefits. However, when it comes to establishing fees contractually, we do not, at this time, see an avenue for legislative or regulatory relief.
I want to assure you that WSDA takes aggressive action on behalf of its members whenever possible. The non-covered benefits legislation and the defeat of the mid-level provider this year are examples. We are as frustrated as you are when we are unable to act on your behalf. But there are circumstances, and this is one of those, where the law prevents our intervention.
The following are some suggestions circulated by the Pierce County Dental Society and the Seattle-King County Dental Society to determine how these changes might affect your practice.
• Go to the WDS website, log in, and go to the Dentists Section and look for the link that says “Fee Schedule Effective 6/15/11.” This is your new fee schedule. You may have either or both Premier Provider and PPO schedules. Print it and see how it compares to your existing schedule. Most dentists have seen a 15% overall reduction. Some have seen a greater reduction and a very few have seen an increase.
• Call WDS and ask them to send you a “Provider Summary.” This will break out claims processed by WDS on your behalf. More importantly, it will summarize the payments made to you broken out by Premier/PPO products. You can take the overall figure and compare it to your office collections for the same period of time. This will give you an idea of how much of your revenue is WDS based.
• Once you have those figures, take the percentage of WDS patients you have in your practice and apply the discount percentage of the new fee schedule to it. This will give you an idea of how your revenues will change.
• You may also wish to study the demographics of your WDS patients. Have they been long term patients who might remain with you, etc.? How might they react to any business decision you might make?
• What we have heard in talking to members is that this reduction goes directly to the bottom line. If no other changes in overhead can be made (staff and dentist salaries, lab or supplies), it affects your operating income to a much larger percentage. You may wish to discuss this as well as the other information gathered above with your accountant.
We hope this information will be helpful in your deliberations.
Dr. Douglas P. Walsh