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The Delta Dental Plans Association, also known as simply Delta Dental, is an American network of dental insurance companies composed of 39 independent Delta Dental members operating in all 50 states, the District of Columbia and Puerto Rico. These member companies provide coverage to 85 million people, enrolled in over 157,000 groups.
A dental discount plan, also known as a referral plan, is a membership-based discount plan for dental health maintenance and intervention. In it, the patient pays the entire cost of a rate negotiated between the dentist and the referring company, usually between 10-60% of normal cost. [1]
With indemnity dental plans, the insurance company generally pays the dentist a percentage of the cost of services. Restrictions may include the co-payment requirements, waiting period, stated deductible, annual limitations, graduated percentage scales based on the type of procedure, and the length of time that the policy has been owned.
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Silent PPOs typically do not make referrals, but provide access to the discount after the service was rendered. Additionally, providers argue that, had the patient not entered via a back-door arrangement, they would not have been given the discount applied to the contract. Thus, the provider loses money from the amount that would have been charged.
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