How do orthodontist have multiple practices?

[llamaoverlord]

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I've seen an orthodontist that has 4 offices ands it's just him and no associates. How does he have time for this? How is he able to care for patients at 4 different locations?

 

[Winged Scapula]

It sounds obvious but he likely has limited hours at each location. He also likely has dental assistants that can handle a lot of the work without his presence, allowing him to travel between the offices.

 

[llamaoverlord]

It sounds obvious but he likely has limited hours at each location. He also likely has dental assistants that can handle a lot of the work without his presence, allowing him to travel between the offices.

Are there any advantages to having multiple offices with limited hours at each office vs one office full time?

 

[Winged Scapula]

Are there any advantages to having multiple offices with limited hours at each office vs one office full time?

Yes.

I have 2 offices - it allows you to cover a wider area of town, to see patients who might not drive to your single office, to draw from a wider referral network around the area and to demand higher reimbursement from insurance companies as you can show them that you can provide services to a larger number of their insured lives.

 

[llamaoverlord]

Yes.

I have 2 offices - it allows you to cover a wider area of town, to see patients who might not drive to your single office, to draw from a wider referral network around the area and to demand higher reimbursement from insurance companies as you can show them that you can provide services to a larger number of their insured lives.

Just to be clear the reimbursement rate is the rate the insurance company pays you back and they don't just give you a lump sum right?

 

[Winged Scapula]

Just to be clear the reimbursement rate is the rate the insurance company pays you back and they don't just give you a lump sum right?

I'm speaking about a rate for services rendered that you contract with the insurance company. I'm not a dentist, but essentially works the same way:

patient X comes in for a procedure which is covered by insurance
they (the patient) pays their co-pay
you bill the insurance company for the procedure performed
the reimbursement rate is the amount the insurance company pays you for that procedure; the rate may be different based on your contract, your location, etc.

 

[llamaoverlord]

I'm speaking about a rate for services rendered that you contract with the insurance company. I'm not a dentist, but essentially works the same way:

patient X comes in for a procedure which is covered by insurance
they (the patient) pays their co-pay
you bill the insurance company for the procedure performed
the reimbursement rate is the amount the insurance company pays you for that procedure; the rate may be different based on your contract, your location, etc.

Thanks but aren't some insurance very slow about it haha?

 

[llamaoverlord]

Also earlier you said that if you have more locations you have higher reimbursement rates does that means your patients pay less Co pay and the insurance company pays more? Or do you just get more money from the insurance company plus the regular Co pay? I don't mean to stray off from the topic, but I want to know more about the insurance and reimbursement rate. Also why do they call it a rate? When you say rate I automatically think like over time.

 

[Winged Scapula]

Thanks but aren't some insurance very slow about it haha?

Yes it can take several weeks to months to get paid. Many companies use electronic claims processing now which has sped things up compared to paper but there still isdefinitely a lag in getting paid.

 

[Winged Scapula]

Also earlier you said that if you have more locations you have higher reimbursement rates does that means your patients pay less Co pay and the insurance company pays more? Or do you just get more money from the insurance company plus the regular Co pay? I don't mean to stray off from the topic, but I want to know more about the insurance and reimbursement rate. Also why do they call it a rate? When you say rate I automatically think like over time.

It's not the fact of having multiple locations that get you a higher rate per se but rather you can argue with the company during contract negotiations that by having more locations you can service more of their insured and provide better service.

The patient still pays the same co-pay and or deductible but the insurance company will pay you more for the services rendered. Please note that this is not automatic and you must negotiate this with them. The average rate paid by the insurance company may also very by ZIP Code so the dentist in your above example may have other offices in areas with a better payer mix or higher reimbursement rates due to the ZIP Code.

Finally I don't know why they call it a rate. If you want to get technical about it the insurance company has a defined allowable payment for certain services and your reimbursement will be a certain portion of that.

 

[llamaoverlord]

It's not the fact of having multiple locations that get you a higher rate per se but rather you can argue with the company during contract negotiations that by having more locations you can service more of their insured and provide better service.

The patient still pays the same co-pay and or deductible but the insurance company will pay you more for the services rendered. Please note that this is not automatic and you must negotiate this with them. The average rate paid by the insurance company may also very by ZIP Code so the dentist in your above example may have other offices in areas with a better payer mix or higher reimbursement rates due to the ZIP Code.

Finally I don't know why they call it a rate. If you want to get technical about it the insurance company has a defined allowable payment for certain services and your reimbursement will be a certain portion of that.

Thanks for all the answers very helpful!