Direct Reimbursement
ODS is excited to introduce DIRECT Reimbursement (DR), a dental product for groups with 51 or more enrolled subscribers. DR is an innovative approach to self-funding employee dental benefits. It is supported by the American Dental Association as a simple and economic alternative to traditional style dental plans.
One of the most attractive features of a DR plan is its simplicity of operation. Under a DR plan, the employee and covered dependents visit the dentist of their choice, receive necessary treatment, and pay the dentist bill directly to the dental office. The employee then submits a simplified claim form to ODS for reimbursement. ODS reimburses the employee for the appropriate amount based on the benefits and maximums selected by the employer.
Benefits are simply stated as a maximum dollar limit per year per eligible individual or a percentage thereof. Reimbursement is based on dollar expenditures rather than on types of services incurred.
Benefits of DR to employers:
- Cost control with use of co-payments, annual maximums and employees desire to spend their benefit dollar wisely.
- No premiums. Payment is made only for those employees who actually visit the dentist.
- 90-95% of the dental benefit dollar is spent on actual dental care.
- Employers can tailor a plan to meet their specific needs and offer attractive benefits while controlling costs.
Benefits of DR to employees/patients:
- Freedom to receive care from their dentist of choice.
- Reimbursement based on dollars spent, not type of treatment.
- No pre-authorization required.
- Simple to understand.
Benefits of DR to the dental office:
- Promotes the dentist/patient relationship.
- Reduces paperwork and delays in the office.
- Freedom to explore the best treatment option with the patient without restriction by a third party.