With morbid curiosity, I read the article "Under Review - Dentists Under Scrutiny: are insurers overusing utilization review" in the November 2000 Dental Practice Report.

 In February 2000, my practice became the subject of such scrutiny by United Concordia.  Several months later, I was able to look back on that harrowing experience as a defining moment in my professional growth.  UCCI told me I would have to predetermine every posterior restoration I placed.

 In 1999, my UCCI income was close to $200,000, nearly 20% of our practice.  I entered into a lengthy discussion with UCCI.  After all, I had been one of the only participating dentists on the Jersey Side of the Delaware River for almost 25 years.  There were never any complaints about me by patients.  Never had the company ever had to request reimbursement for procedures I hadn't performed, nor had they ever accused me of fraudulence.  I assured them that I was using the same diagnostic techniques I always used (i.e. I was not using Diagnodent or AA - which they are obviously prejudiced against).

  It quickly became apparent that UCCI would not pay for 85% of our claims I took immediate action. I carefully dropped my participating status with UCCI, speaking with every family personally first, explaining how their insurance had illegally been changed from a traditional indemnity plan, to a mangled care plan.  Most understood that I was not going to let the insurance company tell ME how to practice. 

 I discussed the mechanics and practice dynamics of this move with others who had already done so.  I thank the dentists of Crown Council and genR8Tnext on the Internet for their help, encouragement and support.  I want to help others, especially young dentists, to become insurance free.  Copies of the letters I used are available on this page.

 Rather than belabor the issues (too many posterior resins), or the sequellae (85% of all claims denied as unnecessary, patients being told by UCCI that there were plenty of other dentists they could see, claims analysts telling me to use fluoride to remineralize rather than fill a tooth) I have chosen to create a web page where everyone can vent their frustrations with UCCI. I invite you to share your issues by emailing me with your name, your complaints, your practice location, and anything else you might think of. 

It is my fervent hope to help others become free of entanglements with insurance companies.  To that end, I have provided, as a resourse, several letters our office has used.

 I was given some false hope last week, when one of my colleagues who sits on the ADA's Dental Care committee told me he was going to Chicago for a meeting to discuss a possible class-action suit against UCCI. I wanted to be the star witness!  The ADA unfortunately, has decided that they would rather negotiate than litigate. I would like to be able to show the committee how pervasive UCCI's utilization reviews have been. Therefore, I would appreciate an email with your story.

 UCCI is the provider for the armed forces.  Please forward your experiences to me, and I will be sure to keep the ADA's Committee on Dental Care, and the Armed Services Committees in Washington up to date about their unfair business practices. 

 UCCI has proven to my patients that it is impossible to diagnose without examining the patient.