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Dental
Insurance Types of dental insurance Dental Insurance in the 2000's comes in three basic types, each differing in the availability of providers and the form of payment to the provider. Indemnity Plans: These plans are the traditional dental insurance plans which have been available since the 1950's. Patients can usually go to the dentist of their choice, and the dentist is paid only for the services provided; therefore, the patient has complete control of the treatment plan. The dentist provider ends up being paid the UCR (usual, customary, and reasonable) fee or a percentage of the UCR fee, with the patient paying the co-payment, or the portion of the fee not paid by the insurance company. These plans usually have the best benefits and cover the largest range of dental services Preferred Provider Plans (PPO): These plans feature a contract between the insurance company and the dentist provider to provide specific dental services. The fee paid to the dentist provider is usually lower than the UCR fee, and the patient may or may not have co-payments. The choice of dentist providers is limited to those providers who actually sign a contract, and many times specific services may be "downgraded" because of the benefits offered. Dental Health Maintenance Organizations (DHMO): These plans mimic medical HMO's in that the services are prepaid. Patients have specific benefits which can be performed during the period the patient is covered under the DHMO. Co-payments may or may not be paid to the dentist provider. Traditionally this type of dental plan has the fewest number of covered services and the most restricted number of dentist providers. Choosing
a dental insurance plan It can sometimes be difficult to choose a dental insurance plan for yourself and your family. Factors include the following: The range of dental benfits desired, the providers available, the fees or the percentages of the fees covered by the insurance, the deductible, the maximum benefit per benefit year, and the waiting periods--if any-- for specific services. Another consideration about PPO's: Many of them will allow the patient to visit the dentist of his choice and although there is no contract, the insurance company will pay the non-preferred dentist provider from a table of allowances. Dental Insurance Benefits in Our Practice Our practice accepts all indemnity plans offered and certain PPO's. We can tell you if the services we provide are covered --if you can give us the name and policy number of your dental insurance policy. Also, we can pre-authorize your dental treatment plan, so that you would know exactly what your co-payment would be. We have found this to be the best method so the patient can be aware before treatment what his/her co-payment would be. During the year 2004, our practice has processed claims from, or provided services for, the following insurance companies: Adventist Health System Aetna Life Insurance Company Aetna PHC Ameritas Life Insurance Blue Cross of California Carpenters Health and Welfare Insurance Company Cass Construction Children's Hospital and Health Center CIGNA Healthcare Benefits County of San Diego Department of Human Resources Delta Dental Plan of California Delta Dental Plan of Minnesota Delta Dental Plan of Missouri Delta Dental Plan of New Jersey Delta Dental Plan of Tennessee Delta Dental Plan of Virginia Employers Health Insurance Fortis Benefits Insurance Company Foundation Health Systems GE Group Administrators Georgia-Pacific Corporation Great-West Life & Annuity Insurance Company International Paper EBRA Metropolitan Life Insurance Company Principal Life Insurance Company RETA Trust Rocky Mountain Hospital and Medical Services San Diego Hospital Association San Diego Unified School District Scripps Health Sheet Metal Workers Plan Southern California Drug Benefit Fund Standard Insurance Company State Farm Mutual Automobile Insurance Company The Guardian Life Insurance Company The Plan Handlers The St. Paul Insurance Company Trigon Insurance Company UFCW Unions and Food Employers Unicare Life and Health Insurance Company United Concordia Washington Dental Service West Coast Administrators West Teamsters Welfare Trust |
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