An Introduction to Dental Benefits

Dental Benefit Plans: An Overview for Dentists

Chances are, a fair amount of the time you spend at your practice each week has very little to do with your clinical training and everything to do with your patients’ dental benefits plans. Making your way through the various dental plans and their restrictions, maximum allowable charges and other limitations, can make even the most benefit-savvy dentist raise their hands in frustration.

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Dental Benefits Introduction

But no worries. Find the topic you need to assist you when handling patient’s dental benefit plans from the list below.

A. Dental Plan Overview

  1. Traditional plans
  2. Dollar-based plans
  3. Cafeteria plan
  4. Health Saving Account (HSA)
  5. Health Reimbursement Arrangement (HRA)
  6. Flexible Spending Accounts (FSA)

B. Types of Dental Plans

  1. Preferred Provider Organization (PPO)
  2. Capitation plan
  3. Indemnity plan
  4. Point of Service
  5. Discount and/or Referral plans

C. Financing of Dental Plans

  1. Self-Funded
  2. Paid Premium
  3. Medicaid
  4. Medicare
  5. Medicare Advantage

D. Management of Dental Benefit Plans

E. Relationships with Third Party Payers

F. Benefits and Limitations

  1. Preexisting conditions
  2. "Usual, Customary, and Reasonable" (UCR)
  3. Annual maximums

G. Coordination of Benefits

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