What is Fee-For-Service vs. PPO (Dental)?
The Short Answer
Fee-For-Service vs. PPO (Dental) explained simply
In dentistry, Fee-For-Service (FFS) means you pay for each dental procedure as it happens. There are no pre-negotiated rates with an insurance company. You pay the dentist directly for their services.
Preferred Provider Organization (PPO) is a type of dental insurance plan. With a PPO, you choose a dentist from a list of providers who are part of the plan's network. These dentists have agreed to provide services at a lower, negotiated rate for PPO members. You usually pay a deductible and a co-payment, and the insurance covers a percentage of the remaining cost.
Real-World Example
Choosing a Dental Plan
Imagine you need a routine cleaning and a filling.
Fee-For-Service: Your dentist charges $100 for the cleaning and $200 for the filling. You pay the full $300 out of pocket.
PPO: Your PPO plan has negotiated rates. The cleaning is $70 and the filling is $150. After your deductible, your plan covers 80%. You pay 20% of the negotiated rate, which is $14 for the cleaning and $30 for the filling. Your total out-of-pocket is $44.
Why this matters
Understanding the difference helps you choose the right dental plan for your needs. It impacts your out-of-pocket costs and your choice of dentists. This directly affects your personal finances and access to care.
When valuing a dental practice, understanding the mix of Fee-For-Service versus PPO patients is crucial. FFS patients often mean higher revenue per procedure, but PPO plans can provide a steady stream of patients. This mix impacts the practice's overall profitability and stability.
When valuing a dental practice, understanding the mix of Fee-For-Service versus PPO patients is crucial. FFS patients often mean higher revenue per procedure, but PPO plans can provide a steady stream of patients. This mix impacts the practice's overall profitability and stability.
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