DentalOptions has created the structure to allow an environment for dentists to provide cost-effective quality dental services. Through this structured environment, insurance carriers, third party administrators (TPA’s) and employers can offer Preferred Provider (PPO) and/or Exclusive Provider (EPO) dental products which result in lower dental premiums and claim costs for employers and less out-of-pocket cost to their employees and family members for dental services received.
The following services are provided with the leasing of the DentalOptions PPO Network:
- Provider Network Leasing: Monthly rental of DentalOptions preferred provider network to their client partners for their dental products in Oregon and Clark County, Washington.
- Provider Communications: DentalOptions would be responsible for notifying our providers of the contract with the clients. We would also be responsible for ongoing communications to our providers regarding any administrative or marketing changes to the contract.
- Provider Directory Updates: We will supply you with a monthly update of our Provider Directory in hard copy, disk format, or as a text file over the Internet.
- Provider Recruitment: DentalOptions is a local company and we do understand the Pacific Northwest dental market. We have good connections to the provider community. If you feel we are lacking in dentists in any area where your clients’ business exists, we will commit a strong effort to getting the necessary number of dentists you consider appropriate to meet the needs of your enrollees in that area.
- Provider Credentialing: DentalOptions has fully credentialed all of its providers through the use of an extensive application, approval procedure, and contractual obligations of the provider. Re-credentialing is performed on an annual basis with the State Licensing Board and on a bi-annual basis for on-site inspections. (See Introduction to DentalOptions for additional detail).
- Provider Peer Review: DentalOptions Peer Review Committee is available to handle dental concerns and grievances. Upon receipt of a complaint, the Peer Review Committee works with the preferred provider to correct the situation. The insurance company, TPA, and/or patient is then contacted within 10 days and apprised of the situation.
- Provider Quality Assurance: DentalOptions will help provide you with quality control because providers must adhere to a contract and are subject to quality assurance audits. In the event of complaints from payors or patients, a Quality Assurance Review Committee reviews the claim and appropriate steps are taken to correct the situation.