Insurance & Financing

Indemnity or traditional insurance reimburses members or dentists at the dentist’s UCR (Usual, Customary and Reasonable fee). This allows the subscriber to go to any dental office without being limited to a panel.

PPO (Preferred Provider Organization) is the most common form of insurance. They provide members with a list of participating dentists to choose from. The dentists on this list have agreed to a lower fee schedule, which provides you with greater cost savings. They also assist with insurance billing.

DHMO, also known as capitated or prepaid insurance, was designed to provide members with basic care at the lowest rate. Patients designate their dentist from participating providers and are assigned to the office. DHMOs may not pay for services rendered. Fees are usually greatly reduced, but the patient is responsible for paying the doctor.

Discount plans simply consist of a panel of dentists that have agreed to a reduced rate, with the subscriber being solely responsible for the entire portion. There is no billing or annual maximums.

Treatment that is recommended by a dentist, is listed on the fee schedule, and accepted under the terms of your group’s plan.

Treatment that is either not listed on your fee schedule or more than the minimum to restore the tooth back to its original function.