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Getting The Most From Your Dental Plans
When you are evaluating or comparing dental plans, we recommend that you consider the following criteria:
| 1. |
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. |
| 2. |
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:
- No balance billing policies.
- Pre-treatment, claims and utilization reviews that will help prevent excessive or inappropriate treatments or billing.
- Regular dental office reviews by the carrier to ensure that dentists are meeting their contract requirements and providing appropriate, consistent care.
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| 3. |
Your carrier should have systems in place that ensure quality care for your employees. Look for:
- Written standards of care that define appropriate dental treatments and outcomes.
- Tools that monitor quality, such as claims reviews, site visits and random audits.
- And, if you are thinking about a managed care plan, choose one that uses the standards established by an independent agency, like the National Committee for Quality Assurance (NCQA), to credential its network dentists.
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| 4. |
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. |
| 5. |
You want a plan that you can monitor. Ask for clear, easy to understand management reports that include the information you need to evaluate the effectiveness of the plan. |
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