Preferred Provider Organizations (PPO)
- Posted on: Dec 13 2010
In Preferred Provider Organization programs you must choose from a specific group of dentists who have agreed to provide minimal dental care for the contracted cost. Participating dentists have agreed to discount their fees so they can be a part of the program, and must often limit treatment options. Treatment choices are usually limited to the least expensive option regardless of desires of the patient for higher quality care.
Patients are funneled or referred to these participating dentist by the insurance network. If the patient chooses to see a dentist who is not designated as a “preferred provider,” that patient may be required to pay a greater share of the fee-for-service. Only about 81% of the monies spent on a PPO program goes to actual patient care. The remaining 19% goes to the insurance company. In a PPO, patients are limited in the choice of doctor and the quality of care they can receive. The largest PPO in Oregon is Oregon Dental Service (ODS).
New Smiles is fee approved for ODS, but we do not participate as preferred providers. Meaning we participate with ODS as an indemnity or UCR program only (see UCR programs). Unlike other indemnity programs, however, with ODS the UCRs are known and accepted fees. Our commitment to the highest quality dental care keeps us from participating in managed care programs, such as PPOs or HMOs (See Our Mission Statement).
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