I am shopping out dental PPO plans. I went to my dentist and I was told by the staffing that they will only accept PPO’s dental insurance plans. As I read though some of the terms in the plans there is something I do not fully understand. What is UCR fees and when would they be applied to your coverage’s?
Reply: 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 maxim 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.