PPO or preferred provider organization seek discounts in exchange for referring many patients

PPO – Preferred Provider Organization – Medical or Dental Health Insurance Plan

This is an intermediate medical or dental health insurance plan which offers mid-level medical or dental health care through a panel (or network) of doctors or dentists.  These doctors or dentists agree to charge PPO patients a discounted rate in exchange for the hope of receiving a high volume of referrals from the insurance company.  The difference between the doctor or dentist’s usual fee and the PPO fee is given up by the doctor or dentist.

Does the dentist usually get enough referrals from a dental insurance plan to compensate him/her for the loss from discounted fees?  Sometimes.  If not, an intelligent dentist will recognize the need to cut costs somewhere to make up for the loss.  Patients may feel they have less time to learn about their diagnosis and/or discuss multiple treatment options.

Frequently, the seemingly smallest details can be more expensive to provide than the dental insurance plan will reimburse.  Patients may find that a general dentist, not a specialist, performs their root canal therapy and it hurts afterwards.  Or the color of a front tooth crown (cap) may not match the surrounding teeth as much as they had hoped.  PPOs can be a reasonable compromise for many patients who need to carefully balance dental cost and care.

–Dr. Jeffrey Dorfman, Director
The Center for Special Dentistry

The Center For Special Dentistry is NOT a member of any dental insurance plan network.