Tuesday, September 17, 2019

Delta Dental Exports Services to Stateside Markets

By on August 16, 2019

Responds to Puerto Rico’s Declining Dentist Population

SAN JUAN — Delta Dental, whose provider network comprises 1,175 dentists in Puerto Rico, or about 90 percent of those on the island, is now expanding its services, not by opening a branch somewhere else, but by exporting to other Delta branches stateside.

Marianne Ortiz Rivera, president & CEO of Delta Dental Puerto Rico, explained that although Delta Dental has a large market share, the island now has some 200 fewer dentists since the medical brain drain worsened. 

The company’s first move was to expand its service. In 2014, Delta Dental went from being a product for groups, also known as commercial, which is the insurance provided by employers, to also accommodate individual plans.

Then, Delta started to create “alliances,” Ortiz Rivera explained, with other insurance companies to manage their Medicare Advantage services. However, having reached a market share that did not leave room for local growth, Delta Dental began looking for ways to provide its services to other Delta Dental branches.

“Initially, this started out as a pilot project for us, to be a safety copy for the United States [companies]. If there was a workers’ strike or any other situation, then we could process claims; that was the initial idea,” Ortiz Rivera said. “We did the pilot project and after we saw that it was Responds to P.R.’s Declining Dentist Population; Expands Stateside with Act 20 to Offer Individual Services successful, then we started working toward the Act 20.”

With Act 20 of 2012, known as the Export Services Promotion Act, the company decided to continue to expand from a once small project to a unit that represents 45 percent of Delta Dental’s workforce, with 50 of the 110 employees covering the operations.

This unit provides services to Delta branches in 16 states, including Georgia, Pennsylvania, Florida, Texas and California, with the latter the largest stakeholder in Delta Dental Puerto Rico, with 64 percent of the shares. Furthermore, if the exported services unit is approved for a call center, Delta Dental would add 20 employees. 

Ortiz Rivera described the unit’s Delta Dental staff as phone work, providing support by completing the entry of claim data that the company’s optical character recognition software (OCR) cannot read. More complex services are performed at the Client Service Center. The CEO explained this is where claims analysts process, analyze and pay claims. The company also investigates complaints. 

Another reason Delta Dental’s services are attractive to other stateside branches, Ortiz Rivera explained, is that “right now, what we do with data entry, the phone work part, is only done in Puerto Rico and Mexico,” and there are group plans that can only be processed in a U.S. jurisdiction. 

Despite the general economic contraction, particularly in the medical industry, Delta Dental has more than stayed afloat, and Ortiz Rivera said the key to Delta’s expansion is diversification. 

“We have different products; we have commercial and individual [services]. In 2018, we launched the Delta Vision product for the commercial sector. So now, we are offering a vision-related product. In addition to that, we have alliances with other insurance companies in which we administer the dental service and export of services. All of this together is what led to the company’s growth,” the CEO said.

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