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Direct Reimbursement and How It Is Marketed By Organized Dentistry - Assignment Example

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This assignment discusses direct reimbursement and how it is marketed today by organized dentistry. The researcher describes the contemporary dental insurance models, that are form of payment for dental care, that has existed informally for a long time and gaining popularity today…
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Download file to see previous pages Indemnity insurers may also allow dentists to charge only a given amount, and the company pays a percentage of that payment. Unlike direct reimbursement, indemnity insurance limits employees on the services that can received or the frequency of seeking such services through selection of services that the company can pay for. In this case, the insurer selects a number of services that the patient can receive from the dentists and expect the company to pay for such services. Indemnity plans bear limitations in which they place restrictions on services covered as well as dictate the fees that can be reimbursed. In both indemnity insurance and direct reimbursement, the patient pays and the insurers pay a certain percentage of the total expenses. In the case of indemnity insurance, the patient pays the difference between the dentist’s fee and the insurance company agreed reimbursement fee (Christensen, 2001). Nevertheless, the two plans differ in terms of the reimbursement process in which the patient pays the total expenses to dentist in the case of direct reimbursement and presents receipts received from the dentists to the employer for reimbursement. Conversely, the insurance company pays part of the expenses as per the capitation or the amount set out in the insurance plan directly to the dentist and the difference between the dentist’s fee and the insurance company’s amount settled by the patient. In both indemnity insurance and direct reimbursement dentists are able to treat any patient possessing one of these plans because a patient is not restricted to see a doctor on a designated list (Paul, 2001). In this case, potential new patients on...
This assignment presents a researh conducted on the subject of direct reimbursement, that involves an agreement between an employer and its employees in which the employer agrees to reimburse the employees for some part of their expenses incurred in seeking dental care. The researcher describes that in this form of arrangement, the patient or employee has the freedom to choose the preferred dentists or organization where to receive the dental care services. In addition, the patient is not limited in terms of the type or number of services that they can receive from the dental health care facilities or dentists. As such, the patient has the responsibility to pay for the services received and the dentist or dental care facility has no responsibility to any insurer in terms of the scope of services or limit on the frequency of services. The researcher then compares and contrasts direct reimbursement and indemnity Insurance. Indemnity dental insurance plans have been funding dental services among the American public for several decades and have been associated with the significant increase in access to dental care. In the direct reimbursement plan, dentist do not have to follow insurers to receive payments for services delivered to a client since the client clears the debt before demanding for reimbursement from the employer or insurer. As a result, direct reimbursement has been positively received and widely advocated for by majority of the dentists’ networks owing to its convenience in terms of reimbursement. ...Download file to see next pages Read More
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