Wednesday, August 30, 2017

Dental Coverage and Dental Facilty, Two Very Different Things

In my experience in the dental coverage industry, I have come to realize that there is a common misconception that the dental center works for or is owned by the dental coverage company. With the changes in the dental coverage industry and the development of in-house plans by the dental centers or corporations that have a dental coverage and dental centers, I can see where the confusion can come in to play. However, in most cases this is not the case.

Dental centers are individual practices or corporate practices. Which means that they are either owned by the dentist or a group that owns the center and hires the dentist.

Dental coverage companies are separate companies such as an insurance company or dental plan that offers discounts on dental services at the dental center.

The connection between the two comes in the form of an agreement between the two entities. When it comes to dental insurance, the dentist agrees to accept the insurance at their office, treat patients that come in, collect the co-pay and bill the insurance company for the remainder. In return, the insurance company will send the dental center new patients and pay the remaining balance.

When it comes to dental plans, the dentist agrees to be a provider on the plan, treat patients and charge the pre-negotiated prices according to the fee schedule. In return, the dental plan becomes a marketing source for the dental center and send them new patients.

Either way, the dental coverage company does act as a liason between the patient and the dental center should the need arise for problem solving.

No comments: