A dental provider directory can be a valuable marketing tool for a dental plan. A large provider directory means more access to care for the members of the plan. And the conventional wisdom is the larger the directory the better.
A provider directory grows in two ways:
- by adding providers (dentists), and
- by adding provider locations (places the dentist practices at).
The combination of providers (dentists) and all the locations they practice at is commonly referred to as access points, or provider/location combinations where a member can “access” care.
The Industry Is Concerned That Access Is Overstated
One of the concerns in the industry regarding the access points counting method is that providers are being listed at more locations than they actually do or can practice at. This phenomenon is due to a few factors. First, just the like rest of us, dentists retire, sell their practices, or die. Second, associate dentists (employees) tend to move from practice to practice. In both of these situations, it is difficult for dental plans to stay on top of this information, and there may be a significant lag when updating provider directories.
Finally, and most importantly, large dental groups with multiple offices ofen require that dental carriers list all of their dentists at all of their locations, even though they may only regularly practice at 2 or 3 locations. This is so that they can easily move dentists around without disrupting claims payment from the carriers. There are more than 1,300 dental groups nationwide with 5 or more locations, with the average group having 13.7 locations, resulting in overstated access in provider directories. (NetMinder, March 2011)