If there are no insurance company controls with Direct Reimbursement, what prevents dentists from inflating their charges or performing unnecessary procedures?
A. With Direct Reimbursement, patients typically pay the dentist, then take a receipt back to their employers for reimbursement. Unlike traditional dental plans that allow assignment of benefits, DR does not insulate patients from the cost of dental care. Patients have an incentive, as well as an opportunity, to scrutinize their dental bills and ask questions about the services. If something appears inappropriate, nothing prevents an employee from changing dentists to get better value. Many people don’t realize that as much as 50 percent of the dentistry performed in United States is still paid for out-of-pocket by the patient. What prevents dentists from inflating fees with a cash-paying patient is the same thing that prevents them from doing so with a patient covered under DR. That reason is competition! With more than 24,000 licensed dentists in California, patients have an ample selection of dentists to choose from. It is the marketplace that influences fees more than any insurance
Related Questions
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