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Direct Reimbursement (DR) is a self-funded dental benefits plan that reimburses an employee for dental care expenses and gives patients the freedom to choose their own dentists. It is a simple, innovative, cost-effective approach to self-funding employee dental plans where everyone in a company can benefit.
Whether you're an employee, a benefits decision-maker or the consultant/broker they turn to, it's important to understand why Direct Reimbursement (DR) is the dental benefits plan for smart companies.
DR works much like reimbursement for employee expense accounts. In fact, administration is as easy as A-B-C:
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A. Employee and/or covered dependents receive treatment from a dentist of their choice.
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B. The employee pays the dentist's bill and presents a paid receipt or proof of treatment to the employer or third-party administrator.
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C. The employee is reimbursed according to the plan design that you choose to meet the company's needs.
Employers Benefit with Direct Reimbursment:
Money is spent when employees receive dental services, so 90-95% of every benefit dollar goes toward dental treatment.
There are no complex claim procedures or forms to complete.
Administrative overhead is reduced.
Employers establish the benefit amount.
Employees Benefit with Direct Reimbursment:
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You know what your benefit amount is regardless of the dental treatment.
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You can choose your own dentist.
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No deductibles, no exclusions, non complicated fee schedules.
Direct Reimbursement Dental Plan:
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Step 1: Choose your dentist
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Step 2: Obtain dental services
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Step 3: Pay for dental services and submit receipt and/or simple claim form
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Step 4: Get reimbursed for your dental services under the formula of 100% of the first $100 of expenses, 80% of the next $500 of expenses, and 50% of the next $1,000 of expenses.
Traditional Dental Plan:
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Step 1: Choose your dentist
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Step 2: Obtain dental services
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Step 3: Pay applicable copays, deductibles or charges associated with dental services and complete any necessary claims forms and paperwork. The amount covered for each type of dental service is determined under a class structure.
To learn more about Direct Reimbursement, contact Lois Annett of Employer Administrative Services Co. at (707) 546-4570.
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