You need to be comfortable in talking and being treated by your dentist of your choice. You need to be comfortable in the fact that your dentist is recommending the best treatment for you. Continuity of care is very important in dental care delivery. Your dental health care will be more effective if you maintain [...]
Contracted dentists have agreed to provide dental treatment at an agreed fee with the health fund. The health funds advertise “no out of pocket expenses’ or “reduced out of pocket expenses” – BUT only if you see one of their dentists.
This is a very good question and you should ask your health fund this question. One health fund has not increased dental rebates across the board since 1994. Many funds do not increase dental rebates annually. Private health funds in Australia have made in excess of $7.2 billion surplus (profit) in general treatment cover in [...]
Health funds have openly and aggressively campaigned to get dentists to “sign up” to their contracted provider arrangements. Health funds are openly promoting to patients that they should see a health fund contracted dentist. Some health funds are offering a higher dental rebate for each item of service if the procedure is performed by a [...]
The Australian Dental Association thinks this very unfair. After all, if contributors pay the same health fund premiums, then all contributors should get the same rebates. If you get a lesser rebate you should pay a lesser premium….
There are very few contracted specialists, and some of these are not members of ADA. This means they fall outside our area of investigation. Some dentists work for corporations who make the commercial decisions for them and they are then contracted to a health fund in this way.
The “preferred practitioners” are not actually preferred because of dental ability but because they meet the fee criteria set by the health funds and have agreed to be contractually bound to the health fund.
Q8. My health fund says my dentist is too expensive and my gap will be too high and says I should see a contracted dentist. What should I do?Dr Adrian Longworth BDSc2019-07-03T18:22:18+08:00
ADA National fee surveys show that dentists’ fees over the 17 year period from 1996-2012 have increased on average by less than 5% annually. You should ask what your health fund average premium increases have been over the same period. The Federal Government has been subsidising health fund premiums by 30%. Whilst this has recently [...]
Q9. If the health funds do not permit the dentists who are contracted to them to increase their fees in line with practice cost increases, is there a risk that the quality of dental care may suffer?Dr Adrian Longworth BDSc2019-07-03T18:22:18+08:00
The ADA believes this may cause “tiered’ levels of care. Preferred contracted provider schemes have not been successful anywhere else in the world. If you pay the full premium you deserve the best care and the same rebate as any other contributor regardless of which dentist you choose to see.
You should send a letter of complaint to the manager of your health fund if you are not happy. You have a right to expect the dentist of your choice will provide the service you need and you will receive the same rebate as other policyholders without discrimination. There are funds which do not have [...]