Why are we not preferred providers?

When you take your account or treatment estimate to your Private Health fund they will almost certainly point out that, if you went to one of their ‘preferred providers’, you would receive higher rebates. We feel it is important to explain the current ‘preferred provider’ scheme so that you understand why at this stage we have decided not to join.

1. ‘Preferred provider’ might suggest that the dentists who belong to the scheme have been selected for reasons of competence or sterilisation standards etc. This is completely false. Any dentist may become a ‘preferred provider’ providing they sign a contract with a Private Health Fund and agree to abide by this health fund’s terms and conditions.
2. The idea of having private health cover is to give the individual freedom of choice with the health professional they attend. It is morally wrong that all Private Health Fund members pay the same premiums for extras cover but that members who attend a ‘preferred provider’ get higher rebates. This completely removes the freedom of choice.
3. In any event, private health payments are not insurance as dental disease is not an insurable condition. What they are is a co-payment. In other words your Private Health Fund agrees to pay something towards the cost of your dental treatment, NOT cover the cost.
4. Under a contract with your Private Health Fund we would not be allowed to reduce our fees as we do now under certain circumstances. Their contract stipulates that we have to charge the usual and customary fee for an item of service each time that item is used. Unfortunately schemes where patients receive higher rebates often lead to instances of over-servicing or fraud.
5. Many Preferred Provider Dentists send their patients laboratory work (i.e. Crowns and dentures) to a laboratory who in turn sends it overseas (mainly Indonesia and China). This saves a significant amount of money (up to 25% on the total cost of a crown) but in a vast majority of cases the work is of poor quality. The types of metals and plastics used are often unknown and can lead to an early failure. We certainly want to know which products we are placing into the mouths of our patients! We take great pride in using high quality Australian dental laboratories with experienced technicians, using high quality materials to fabricate the final product. In order to reduce costs some Preferred Providers have to decrease the time spent on treatment and use less expensive materials which can lead to an early failure of the restoration. Quality Dentistry takes time and we are not prepared to compromise.
6. The Australian Dental Association does not support these ‘preferred provider’ contracts and believes their intent is that the Funds will eventually be able to control the level of fees and services. In other words your dentist may not be able to provide the treatment that he or she feels to be in your best interests as, by doing so, it may breach fund rules current at that time.

We trust that this explanation allows you to make up your own mind on this matter. Please do not hesitate to contact the practice if you wish to discuss this issue further. If you value good service and honest advice, then you must have a direct relationship with your dentist, and not one which has an insurance company influencing such an important relationship.