Direct Dental Reimbursement Plans

[Guest MikeMarsh]

Looking for information/experience/etc. on direct dental reimbursement plans. Everything I've found so far is either ADA backed propaganda or carrier backed propaganda!!!

[Guest Phil Cohen]

Oh No! Someone wants the truth!!!

Whether or not Direct Reimbursement (DR) plans make sense for your firm will depend on several factors and, more importantly, the goals you are trying to achieve (how was that...vague enough?).

Seriously, DR plans do what they are designed to. They are very simple in nature. The assumption that needs to be made is utilization. If more "insured" use the program than anticipated your firms claims cost will be higher. clearly you know your maximumn liability, the trick is figuring out where the actual cost will fall based on utilization.

If you do not have someone performing claim review then you are making the assumption that all dentists are angels and would never over bill and/or never perform work that is unneccesary. On the other hand, the ADA would have you believe all insurance carriers are evil. Big surprise, the truth is somewhere in the middle.

Whether you should go fully insured, self insured or pure DR really depends once again on your firms goals and objectives. Simply stated, DR plans do exactly what they are designed to do, nothing more or less.

I'd be happy to discuss this further with you if you would like to go into greater detail.

Thanks,

Phil Cohen

Broad Reach Benefits, Inc. www.voluntarydental.com