Preferred Provide Network

Preferred Provide Network (PPO)

The article wishes to provide its readers with information on PPO, and later intends to shift its focus to dentistry trends here to come. To begin with, a dental insurance is prepared in such a way to provide one with dental needs and care. There are different kinds of insurances present to cover individual, family or dental groups. All of them can be categorized in mainly three categories namely:

  • Indemnity or dental insurance
  • Dental Health Managed Organizations (DHMO)
  • Preferred Provide Network dental plans (PPO)

Preferred Provide Network (PPO)

  • PPO works similar to DHMO but additionally use an In-Network facility. It helps the patient to choose Non-Participating or Out-of-Network provider.
  • If there is any fee demanded more than covered under the insurance, it becomes the responsibility of the patient to pay it off.
  • To the convenience of the patient there is benefit of prevailing for an annual maximum benefit scheme, but if once it is exhausted before it officially ends, the additional treatment fee lies in the responsibility of the patient.
  • This annual maximum limit is issued every year. This reissued date may vary from plan to plan.
  • Dental insurance companies are bound to divide everything ranging from services, procedures into categories or benefits.
  • They have to refer all this with American Dental Association (ADA) 3-4 Digital Code.
  • The enrollment process may vary, but usually the members are given their specific policy or identification number.
  • After redeeming the dental services, a claim needs to be filed with the dental insurance companies.
  • Depending on the insurance prevailed by the patient, further the application is processed by the dental office.

Many sites claim at the increasing trend seen in PPO services. One such site, www.netminder.com, claims that “out of top 15 PPOS, 13 have one or more partners.”

Additionally to support the fact of increasing PPO trends, the data suggests that more and more dentists are joining the growing network.

The data from 2009 to 2013 prove that there has been a remarkable increase in average number of network per dentist has increased from 6.2 to 7.4.

There are many reasons attributed to this increase in trends and Dr. Mark B. Cooper, a dentist and a practitioner of management consultancy, attributes it to the following:

  • Medicine is always followed by dentistry.
  • The costs continue to grow.
  • There would be a lot of pressure from third parties.
  • The dental industry is so fractured that 86% of the whole practices alone.
  • The dental industry is recession resistant and growing at a rate of 5% annually.

Visalia, a city situated in California, USA is likely to see and feel the growing dentistry trends as out of the 15,223 student population of the city, 1,252 are already enrolled in schools that offer dental education and programs. Dentistry in Visalia is definitely going to affect the whole of the dental industry soon.