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Evaluating A Dental Plan
When you're evaluating or comparing dental plans, we recommend that you
consider the following criteria:
- A good dental plan provides higher coverage for preventive and diagnostic services (i.e.,
cleanings and x-rays) to encourage members to visit their dentist regularly.
- If you are looking for comprehensive dental coverage, make sure you purchase a dental
plan, not just a discount plan. True dental plans offer financial and quality advantages.
Look for a dental plan that has written contracts with a network of participating
dentists. The contracts should include:
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No balance billing policies. |
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Pre-treatment, claims and utilization reviews that will
help prevent excessive or inappropriate treatments or billing. |
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Regular dental office reviews by the carrier to ensure
that dentists are meeting their contract requirements and providing appropriate,
consistent care. |
- Your carrier should have systems in place that ensure quality care for your employees.
Look for:
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Written standards of care that define appropriate dental
treatments and outcomes. |
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Tools that monitor quality, such as claims reviews, site
visits and random audits. |
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And, if you're thinking about a managed care plan, choose
one that uses the standards established by an independent agency, like the
National Committee on Quality Assurance (NCQA), to credential its network
dentists. |
- Your dental plan should offer easy access to local dentists. Take a close look
at the plan's network. As a rule of thumb, all employees should be within 10
miles of a participating general dentist in urban areas and 20 miles in rural
areas.
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