February 3, 2010

Dental Fee Schedule: What is it?

A dental fee schedule is like a price list. It shows the costs for each type of dental work you may want to have done. A dentist may set up her own dental fee schedule. Or, she may agree to use one that is part of a dental plan.

The Dental Fee Schedule and Dental Insurance: What You Need to Know

If you think you may buy a dental plan, you should know that dental plans come in two basic types. One type is “fee for service.” The other is “managed care.”

Whatever the dental fee schedule costs may be, remember: prevention is always less costly than restoration.

Whatever the dental fee schedule costs may be, remember: prevention is always less costly than restoration.

Unlike managed care plans, fee for service dental plans pay your costs only after they receive and review the bill. This means when you use a fee for service dental plan you’ll make higher out of pocket payments.

Some patients may see this as a useful expense. That’s because fee for service plans let patients choose from among more dentists than managed care plans.

Managed care dental plans place more rules on the range of dentists from which you can seek care.  These plans also make the dentists they work with use the plan’s dental fee schedule.

This is good to know. Dental fee schedules most often top out based on the UCR, which stands for usual, customary and reasonable fees. The dentist sets what is “usual” or “reasonable.” The dental plan sets the amount deemed “customary.” The two parties’ numbers do not always match up.

If you have a managed care dental plan, in most cases the dentist has agreed up front to the fee schedule set by the plan. If you have a fee for service plan, you don’t have the same assurance as a rule. You may then end up with higher fees for certain types of work.

Doing the research can save you money

No matter which type of dental insurance you choose, be sure you get to know the plan’s fee schedule. It shows how often the provider changes the plan’s fee levels, as well as how the provider will share these updates with you.

It’s also vital that you learn what part of the cost the dental plan will pay for the types of work spelled out in the dental fee schedule.

Are you looking for high quality, affordable dental plans? Apply for coverage today! 

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