Dental Insurance Customer Service is Getting Worse…
About 10% of our patients have dental insurance through Delta Dental of Illinois. As a general matter, they’re a pretty terrible payer. Their reimbursement rates are all over the place and about half of their claim payments get mailed as checks to the patient resulting in a complicated billing workflow that confuses everyone.
But I’ve grown accustomed to those peccadillos over time.
What really frustrates me is a shift I’m noticing industry-wide where dental insurers are making it increasingly difficult to speak to a provider service agent over the phone.
At the start of the year, Delta Dental introduced a new welcoming message to their IVR: “Thank you for calling Delta Dental…Great news! We’re updating our online dentist portal….Please visit our website…Please bear with us, we’re experiencing high call volumes and may not be able to assist you at this time…if you call between 7 AM and 8 AM you will be able to reach a live agent…” That message repeats itself for two minutes. If you’re patient enough to get through that pre-recorded message and attempt to advance through the automated call workflow, you end up getting routed back to the introductory message. Even worse, if you attempt to call between the suggested hours of 7 AM - 8 AM, you get put on hold for 20 minutes and then the first question the live agent asks is if you checked the website to see if the issue for which you’re calling has already been resolved.
It’s not just Delta Dental of Illinois. My average wait time to speak to a MetLife or BlueCross BlueShield of Illinois agent is 40 minutes. GEHA requires a PIN code to speak to a live agent (which you can only get by fax). Delta Dental of Massachusetts redirects you to a portal that frequently ends in a 404 error. Aetna redirects Medicare Advantage claim inquiries to Availity but Availity doesn’t have claim inquiry capabilities for that payer. Jamie and I purposefully left the BlueCross BlueShield of Illinois FEP Medical network because it was impossible to ever get a hold of anyone on the phone to answer claim inquiries. The only payer that is any good at it is Humana (who admittedly has a very effective provider service workflow).
I used to work in operations for BlueCross BlueShield. I ran a call center. I get it. Predicting call volume over time is difficult. Labor is expensive. Insurance products are complicated and the regulatory infrastructure is constantly shifting. I understand the desire to drive calls to a self service channel in order to enhance satisfaction scores and reduce the reliance on staffing models to handle dynamic call volumes over time. I even understand deploying AI agents to help out where the use case allows it.
What I don’t understand is purposefully choosing to run a shitty operations regime and degrading the customer service surrounding core products. Delta Dental of Illinois is doing that. GEHA is doing that. BlueCross BlueShield of Illinois is doing that. I think those companies are making a calculated business decision in the face of difficult business conditions. And I realize that I’m on the wrong side of that decision. That’s fine. But if they don’t figure it out (through some combination of staffing and technology updates), providers are going to start leaving these networks because they are too difficult to work with.