If something appears inappropriate, nothing prevents an employee from being able to change dentists and seek better value for their dollar in the future. Many don't realize that 50 percent of the dentistry performed in this country is still paid for out of pocket by the patient. With over 24,000 licensed dentists in California, patients have an ample selection of providers from whom to receive care. It is this marketplace that influences fees much more so than any insurance company. According to the American Dental Association, only 55-60 percent of people who have dental benefits in this country ever visit a dentist in any given year.
Dental utilization is very predictable.
If an employer wants to know what a potential Direct Reimbursement plan might cost, CDA offers cost projections using a formula based on national averages that takes into account individual factors of a company. Direct Reimbursement simplifies the way benefits are paid, so most employers can comfortably administer a plan themselves. In many ways, DR is very similar to travel expense reimbursements for employees who travel on company business. Employees turn in receipts and are reimbursed for their expenses. Experience has shown that only about one man-hour per week is required to administer a plan for every 100 employees.