WooKwon Park, DDS
Proudly serving Lewisville, Coppell

I was told to have a PPO dental insurance. But what is it?

July 14, 2016
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Posted By: WooKwon Park DDS

Your Human Resource at your work said you now have a dental insurance and it's PPO.

OK, good but what is it and how does it work, you may ask?

 

Here are some definitions of few dental insurance and how they work. These definitions are acquired from Delta Dental.

Dental PPO Plans

Dental PPO (Preferred Provider Organization) plans offer a network feature and usually offer a balance between lower costs and dentist choice. PPO dentists participate in the network thereby agreeing to accept contracted fees as payment in full rather than their usual fee for patients with the PPO. When you visit a PPO dentist, you typically pay a certain percentage of the reduced rate (called coinsurance) and the plan pays the rest. The percentage usually varies by the type of coverage such as diagnostic and preventive, major services, etc. For example, preventive services may be covered at 80% (you would pay 20%), while crowns and bridges may be covered at 50%. PPOs usually require you to meet a deductible and have an annual maximum amount of coverage (example: $1,000 per year).

 

Dental HMO or DHMO

Dental Health Maintenance Organization (DHMO) plans require you to choose one dentist or dental facility to coordinate all of your oral health needs. If you need to see a specialist, your primary care dentist will refer you; specialty care may require pre-authorization.

A typical DHMO-type plan doesn't have any deductibles or maximums. Instead, when you receive a dental service, you pay a fixed dollar amount for the treatment (a "copayment"). Often, diagnostic and preventive services have no co-payment, so you pay nothing for these services. However, generally if you visit a dentist outside of the network, you may be responsible for the entire bill. 

 

Since DHMO insurance offers very little reimbursement for any dental service unfortunately, dental offices that accept DHMO need to see higher number of patients than one that takes PPO insurance. Because of it, amount of time a doctor can spend on a patient might have to be affected to see all the patients waiting for the doctor.

Park Dental Clinic does NOT accept DHMO because we value each and every patient's time with us highly and we do not compromise anything for our patient's optimal oral health. 

We accept most of major PPO insurance and will do the due diligence on your behalf to help you take advantage of your dental insurance.

If you are not certain what kind of dental insurance you have, simply give us a call. We will gladly call your dental insurance to verify for you!

 

Park Dental Clinic

771 W. Round Grove Rd #W100 Lewisville, TX 75067

469-293-2530

If you have difficulty using our website, please email us or call us at (469) 293-2530
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Dr. Park & Team