Insurance Online

So, let’s consider the second kind of dental insurance in more detail…

II. Direct reimbursement

A new form of services payment which has appeared as alternative of HMO and the traditional kind of insurance (for more information you can explore the post Dental Indemnity Insurance). It is the self-financed plan according to which the employer pays the certain percent from the sum for dental treatment of the worker from the special fund. The insurance company (”middleman”) is actually switched off from the process, that is why the administrative expenses were decreased. The worker visits a dentist, pays for his/her work and receives the receipt for the given services. Then he brings this receipt to the employer, and receives compensation of his expenses from the dental fund of the company. The employer chooses the percent of payments which he can compensate to you, and the annual maximum of the plan.

Features of the plan:
1) there is no preliminary payment, lists, exceptions, monitoring of procedures performance, etc.;
2) low payments (on the average, 30%-75 % is lower, than in other plans);
3) a choice of a dentist at own will;
4) fast assignment of your reception.

There are two kinds of payment: compensatory and payment for the purpose. When the worker choose compensatory payment he settle the account, the check will be sent in the Department Direct Reimbursement (DDR) - the compensatory check will be sent to the worker back - the worker pays services of the dentist or uses indemnification to compensate the previous check.

When we speak about the payment for the purpose we mean that the worker settle the account - the check will be sent in DDR - the compensatory check will be sent to the dentist - the worker pays residual balance only.

The majority of employers choose the compensatory kind of payment. The advantages of this desidion are the following: the average expenses are lower, than in the second kind since only the worker is responsible for the settling the account.

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Yours sincerely,
AlexSandra

This entry was posted on Wednesday, August 23rd, 2006 at 5:22 pm and is filed under Dental insurance. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.