Cost Containment Alternatives
The challenge for dental plan sponsors is how to design a plan that covers the participant’s need while staying within budgetary guidelines. At DDS Inc. we have found that the key element is the dental PPO.
Our provider networks:
- Accept discounted fee schedules that are approximately 30 –50% of UCR
- Have all claims over $300 peer-reviewed with relevant x-rays by licensed dentists, not clerical staff
- Use private practice neighborhood professionals
- Are fully credentialed
- Include general dentists and specialists in over 40 states
- Size and scope of the provider networks can be tailored to fit the group demographics and fee schedule. For example, in the New york Metro area, we have 3 different panel sizes with corresponding fee schedules.
DDS Inc. offers a range of options to keep the cost on target. Other methods include varying the dollar amounts of:
- Patient co-payments
- Annual deductibles
- Annual maximum benefit payments
- Orthodontic riders
- Freedom of Choice allows patients to choose in or out of network providers.
- Easy to Understand Benefits, with a schedule of payments that shows exactly what amount is payable for each covered service and whether the patient has any out-o-pocket expenses.
- Treatment in as Few Visits as Possible, because with fee-for-service plans the dentist has a financial incentive to finish treatment. Compare this to capitation programs, where multiple visits add up to work never completed and patient frustration.
- Customer Service Representatives who are responsible to make sure that the patient is satisfied with the services that were performed by panel dentists.
- Explanation of Benefits (EOB), mailed with the reimbursement checks.
- Cobra Benefit Processing
We also offer PPO services throughout most of the continental United States.