Dental insurance, What are UCR fees
I am shopping out dental PPO plans. I want to day with my dentist and I am told by the staffing that they will only take PPO’s. As I read though some of the terms in the plans there is somthing I do not fully understand. What is UCR fees and when would they be applided to your coverages?
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Posted on Sunday, Sep. 26th 2010 8:57 AM | by Dental | in Dental help | 2 Comments »
Monday, Sep. 27th 2010 11:06 AM at 11:06 am
UCR fees or Usual Customary, and Reasonable:
It is common for PPO’s to pay out to what fair and reasonable or UCR. Normally when you stay with in the plan provider data base those dentist have adjusted their cost to stay within the dental company max pay out amount. Therefore staying within the plan network of dentists helps you to avoid UCR fees.
But since you are able to go out side their network of providers you may pick a dentist that charges more then the company is willing to pay out for an individual dental service. This is when you can be bill for the different of what the company is willing to pay out on, and what you are covered for.
Monday, Sep. 27th 2010 11:09 AM at 11:09 am
It is true that you are more likely to have UCR fees when using a dentist that is not in the PPO plan network of providers. However, it can sill happen even with dentist in the network.
In order not to get hit with surprised billing after the fact. Have your dentist submit the claim as a quote before any dental work is started. That way you will know your cost before you go head and have the work done. This can help you control your cost buy then questioning your dentist and shopping out for the best rates.