Abstract
This comprehensive guide explains dental insurance complexities for new associates and practice owners. The author distinguishes dental insurance from medical insurance, noting annual benefit caps of $1,000-$2,000 versus unlimited medical coverage. Four main plan types are detailed: PPO plans (most common, flexible), HMO plans (lower costs, network restrictions), Indemnity plans (no network limits, higher costs), and Discount plans (membership programs, not insurance). Key business considerations include in-network versus out-of-network decisions, with in-network providing patient attraction but reduced reimbursements, while out-of-network allows fee control but limits patient base. The article addresses practical challenges including write-offs (difference between standard fees and insurance allowances), proper coding requirements, and patient education needs. The author emphasizes understanding insurance's impact on treatment acceptance, patient behavior, and revenue cycles as essential for strategic practice decisions and quality patient care.
Recommended Citation
Patel, Amrita D.D.S.
(2025)
"The New Professional: Demystifying Dental Insurance for the New Professional,"
The Journal of the Michigan Dental Association: Vol. 107:
No.
6, Article 5.
Available at:
https://commons.ada.org/journalmichigandentalassociation/vol107/iss6/5
Included in
Business Administration, Management, and Operations Commons, Insurance Commons, Other Dentistry Commons
Submit Article
