Royal Park Dental accepts ALL health funds but we are not contracted to specific health funds. Therefore, we are not “Preferred Provider” or "Members Choice" clinic. We believe that private health funds should not influence your right to choose the dental clinic providing your care. Rather, we believe you should see the dentist YOU PREFER to see, choose a clinic that you are comfortable with, and be sure that your dentist knows you, is able to provide continuation of care, and is giving the best treatment available not one that meets a health fund’s pre-set terms and conditions.
Some health funds are engaging in aggressive marketing and telling their patients that they have to attend “Preferred Provider” or "Members Choice" clinics in order to receive dental treatment and to maximise rebates under their insurance policies.
“Preferred Providers” are NOT preferred because of their dental ability, but because they make a financial agreement with the health fund. Health funds then advertise “higher rebates” or “no out of pocket expenses” but only if you visit one of their dentists. If you exercise your choice and right to see a non “Preferred Provider” or "Members Choice" clinic, you’ll then be punished and penalised, i.e. you will receive lower rebate. In addition, health funds impose annual limits on the amount you can claim. If you receive higher rebates back at a "Preferred Provider" clinic, you will reach the limit of what you can claim sooner and then be out-of-pocket. Unfortunately, the health funds focus is to encourage you to go to clinic that they have financial arrangements with because it benefits them to do so, particularly once your limit is used up.
It is very unfair if you pay the same premiums as “John Smith” but get lower rebates because you go to the dentist you prefer. If you pay the same premium, you deserve the best care and the same rebates as other contributors, regardless of where you go.
Once a dentist enters into an exclusive arrangement with a health fund, the funds may reduce their rebate over time, while the dentist’s overheads will probably increase. This means the “Preferred Provider” dentists may work at an increased speed and use cheaper quality materials to maintain their income. Some dentists unfortunately may start to cut corners or make decisions about treatment based on the best rebate payments offered by the health fund, rather than what is the best option for you. There are examples of over-servicing and sending lab work to cheap overseas dental laboratories when decisions are made based on health fund rebates. The health fund has therefore interfered in the decision-making process about your care. The NHS in the UK is an excellent example of the poor level of dental care provided when a third party is the major influence on dental treatment decisions.
At Royal Park Dental, we decided not to join the “Preferred Provider” scheme due to the implications contracted dentistry will have on the quality of dental care available to Australian families. In summary,
(I) The Australian Dental Association (ADA) does not support ‘preferred provider’ contracts and believes that maintaining patient choice is a crucial element to maintaining high standards of dental care in Australia. The ADA believes that contracted dentistry may cause “tiered’ levels of care and that its implementation has not been successful anywhere else in the world.
(II) Preferred providers are not chosen based on their ability but rather because they meet the fee criteria of the health funds and have agreed to their contract terms. Standards of practice are not the private health funds’ top priority.
(III) Under a contract with a Private Health Fund, dentists are not allowed to increase their fees in line with practice cost increases. In this case, the quality of dental care may suffer due to resorting to cheaper alternatives. At Royal Park Dental, we take great pride in working with only the highest quality dental labs, using state-of-the-art equipment and the highest quality materials. We are not willing to trade our standards for cost cuts.
(IV) Contracted dentists are not allowed to reduce their fees, as we may do with certain conditions, because their contract stipulates so. This may lead to overcharging the patient to meet the customary private health fund fees.
(V) Private Health Fund members pay the same premiums and should, therefore, get the same rebates regardless of their dental provider. It is morally wrong for patients who wish to exercise their freedom of choice to get lower rebates. If these patients are getting a lesser rebate they should be paying a lesser premium.
Questions to ask your Health Fund:
Why are you telling me I can’t I see the dentist I prefer if I am paying the same premiums as someone who goes to a “Preferred Provider”?
Why haven’t my rebates increased in line with premium increases?
Why doesn’t the fund charge me lower premiums if I am getting lower rebates back for seeing the dentist I choose to see?
Other Questions to Consider:
Why do dentists make financial arrangements to be “Preferred Providers” with health funds?
Was it because they had trouble filling their appointment book? If so, why?
Are you really getting value for money from your extras cover?
What can you do as a patient to ensure the best care available?
Choose a dentist based on personal recommendations and word-of-mouth. This is our biggest source of referrals at Royal Park Dental. We do not need to rely on arrangements with health funds to secure our patients.
Discuss your treatment and the cost with your dentist. They want to look after you and develop a personalised treatment plan, tailored to your needs.
Review your health insurance policy and ask your health fund the above questions.
We strongly believe that joining the “Preferred Providers” scheme is not in our patient’s best interest.
However, we believe in your right to make an informed decision and hope this explanation was helpful and allowed you to form your own views regarding the matter.
