Building And Counting Networks: Might Makes Right

We talk in abstract terms about the importance of accurate network listings. Here’s a specific, real-life example of what we mean.

One of our sales executives received a message from an agent a couple of weeks ago. A competing dental-insurance carrier was challenging our network listings, claiming they overstated the strength of Delta Dental’s network and understated the competing carrier’s network.

As proof they supplied their own network listings for a large metropolitan-area chain of dental clinics.

The agent passed on the accusation to the sales executive, who passed it on to me.

When we get these sorts of things – and we get them more often than you’d think – we have a standard protocol for addressing them.

First, we have a scrupulously maintained database of dentists – all dentists statewide. We have not only their network affiliation with us, but their affiliations with all the major carriers. We know at a glance who the dentists are in a county or city, what networks they belong to, and whether they practice at more than one location. We update this information monthly – or more frequently, if circumstances warrant.

In this case, the competitor had produced a listing of 24 dentists, and claimed they were all practicing at the stated locations. We found that only 10 were practicing where the competitor claimed they were – but better than that, five of these “active” dentists had not been practicing at that location for two years. Four more “active” dentists had been inactive for more than a year.

But we didn’t stop there. We picked up the phone and called the offices in question. We asked them, “Could you please tell me what dentists are practicing in your office?” The answers we received from three of the four offices corresponded perfectly with Delta Dental’s network listings.

We didn’t receive an answer from the fourth office on the competitor’s listing. It was closed – because there was no provider to practice there.

In less than five minutes we were able to show that a competitor’s listing that was touted as being 100 percent correct was actually less than 42 percent correct. And Delta Dental’s listings were 100 percent correct.

This isn’t an accident. Other carriers have a couple of professional-relations representatives to cover the entire nation. Delta Dental’s has two professional-relations experts that cover the state, visiting offices and auditing locations for accuracy—plus we devote a lot of time and effort to analyzing everyone’s network listings. We put them on a common footing and see whose numbers truly are the largest.

Coincidentally, we just released a video that talks about our approach to building and counting networks. Visit http://www.deltadentalwi.com/Alert-Resources-Aug13 and you’ll see what we mean.

We appreciate challenges like this. Personally, it gets me fired up. It’s not only an opportunity to set the record straight, but it’s another opportunity to help our agents and employers stay informed and succeed.

Next time we’ll look at how “industry-standard” numbers might not be so standard, and what we do on our end to ensure our network numbers are as accurate as possible.

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