Upfront fee system helps clientele and practice.

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Even before the national economic tsunami hit two years ago, Moon, Pa., dentist Robert J. Baker and office manager Marie Lindeman noticed that more of their patients had started paying cash for checkups. Others simply had stopped coming, except when an abscessed tooth became unbearable.

It was no surprise, really. With an office in the heart of US Airways territory, many local residents were employees of the airline who lost both their jobs and their health insurance.

When the 2008 economic slump added even more patients to the list of uninsured, Baker decided to do something about it.

Beginning in August, Baker’s solo dental practice has been offering what he calls “memberships” to his dental services.

For a prepaid $200 a year (and $150 for each additional family member), he provides two exams, two teeth cleanings, one set of X-rays and a teeth bleaching kit that includes a $200 teeth whitening appliance. He said those services would otherwise cost more than $500 (or about $300 once a patient has the teeth whitening appliance). He also offers a 20 percent discount for all other procedures.

So far, 50 patients have signed up, Baker says, and another 175 have expressed interest in doing so next time they’re due for an exam.

“We’ve heard it for years and years, that they don’t have insurance,” said Baker. “When someone loses a job, dentistry becomes a luxury unless you’re in pain.”

The program is the brainchild of Ashland, Ore., dentist Dan Marut and his office manager and wife, Samantha Marut. About a year ago, they started their own company, Quality Dental Plan, that sets up a customized program for dental practices that offers the uninsured an alternative to standard preventive dental care.

The plan is not insurance, but rather a membership “like Sam’s Club or Costco,” Baker says.

That, in fact, is the key to the program, said Marut in a phone interview Monday: eliminating the third-party insurer from the equation.

“With QDP there is no middleman or third party. Patients deal directly with the doctor. There are no paperwork hassles, waiting for payments, or mountains of follow-up hassles that the office needs to deal with,” he said. The labor and paperwork of handling insurance claims and collections cost a practice money, he said, “and if we can eliminate that cost, the patient will save, and the office is not spending man-hours dealing with insurance.”

Baker says he’s spending about $5,000 a year for Quality Dental Plan’s proprietary services that helped set the program up and keep the back office operations working smoothly. Although not a franchise, Marut says the agreement is “franchise-like” in the sense that Quality Dental Plan restricts the number of dentists in its program based on population.

Marut, a graduate of Penn State and the Temple University’s school of dentistry, said Quality Dental Plan currently contracts with about 60 dentists nationwide with “at least 40 or so” waiting to sign on.

Although dentists can choose which services they offer with memberships, Marut said nearly all included teeth whitening, which is not typically covered by insurance plans.

“Patients love it. It’s a great service,”he said, and not just for cosmetic reasons. “If people are returning to the job market, or just trying to get a job any way they can, they can improve their appearance and improve their self-confidence. And I think that’s great.”

Baker expects to cover the Quality Dental Plan fees, and perhaps more, with increased patient volume. More importantly, he said, patients without insurance will be able to get basic dental care.

“At lot of times we don’t see them until they have a problem,” said Baker. With the Quality Dental Plan program, “at least you can catch things when they’re small. When you don’t, the cost is obviously higher.”

Baker said his office was also looking at marketing the program to small businesses that are struggling with the cost of a dental care benefit or have dropped it already. A major selling point would be that a business would know exactly how much it would cost to offer coverage.

Contact Steve Twedt at stwedt@post-gazette.com.