e-mail Print Share

Education on Dental Plans

Webinar Recordings

January 27, 2017: Coordinating Benefits: How Much of My Fee Should I Write-off?

Click here to view a recording of the webinar

Click here to view a recording of the question and answer session

July 26, 2016 Signing the Contract: Understanding PPOs

June 21, 2016 Advocacy and Third Party Issues

Learn More About Dental Benefit Plans

Most dental offices need to interact with dental plans on behalf of patients seeking care at their practice. It is important that every dental office is educated on how dental plans work. Read more about Dental Benefits. Don’t forget to watch short tutorials on select topics at the Dental Benefits Video Series.  Tutorial topics include:

Part 1: Signing the Contract: Understanding PPOs
Part 2: Common Processing Policies
Part 3: Coding on a Claim Form
Part 4: Avoiding Claim Errors & Addressing Denials
Part 5: Discount Dental Plans and In-office Dental Plans
Part 6: Complying with Commercial Dental Plans Audits/Reviews
Part 7: Bitewings and Extraoral Image Procedure Codes
Part 8: Coordinating Benefits: How Much of My Fee Should I Write-Off?
Part 9: Making Sense of EOB Language

Today’s Plans

According to data from the National Association of Dental Plans:

In 2014

  • 204.6 million people (64% of the US population) had a dental benefit—up from 170.5 million (57%) in 2006.
  • PPOs accounted for 82% of the dental plans in the market—up from 62% in 2006.
  • The commercial market had 77.9 million people (52%) with fully insured dental benefits versus 71.1 million (48%) with self-funded plans. 
  • 47% of PPO plan maximums (in-network) were $1500 or more per year, compared to 55% in 2011.
  • The percentage of PPO enrollees (in-network) reaching, or exceeding, plan maximums was 2.8%, while 1% (out-of-network) reached the same annual maximum.
  • Use of in-network services from PPO networks is clearly trending up with 79.6% of procedures performed in-network for PPO plans.
  • 23.5% of group dental policies are fully employee paid (i.e. voluntary) up 1.5% from last year. 6.5% of group dental coverage is completely paid for by the employer, up from 5.4% a year ago.

In 2015

  • The average PPO premium per enrollee per month was $31.9, down 1.5% from 2014.  DMHO premiums increased 2.3%, and indemnity premiums 8.5%, from a year ago.

Additional research from the ADA’s Health Policy Institute sheds more light into issues related to the dental benefits industry.

Don’t see a topic you are looking for? Let us know at dentalbenefits@ada.org