Frequently Asked Questions

Dental PPO's
What is a Dental PPO and how will it work for our company and our groups?

A dental PPO is a formal agreement between a purchaser of a dental benefit program and a defined group of dentists for the delivery of dental services to a specific patient population, as an adjunct to a traditional plan, using discounted fees for cost savings. DenteMax can lease its dental PPO network, providing access to network dentists to your various group members with rates that are competitive and discounted from traditional dentist fees.

Why should we offer a PPO over other dental insurance options like an HMO?

Most dentists are willing to accept PPO networks and participate in them as opposed to other options. According to the American Dental Association there are 181,709 professionally active dentists in the United States and 116,978 are participating in a dental PPOs. Dental PPO’s have gone from 39% to 74% from 2001 to 2010. This represents the largest plan type avaliable.

Why should we consider getting into the dental business?

The dental insurance business offers excellent profit margins. It allows you to increase your foothold with the groups you represent by offering them additional product options. Additionally, with the current changes occurring in healthcare legislation with the Affordable Care Act (ACA), many individuals will be exploring their healthcare options and potentially adding new benefits like dental insurance. Adding the DenteMax PPO network may provide an excellent opportunity to recapture or earn new business. DenteMax offers the largest leasable PPO network in the country with quality, credentialed dentists.

Working with DenteMax
Is the transition to the DenteMax PPO network a seamless process? Will your data work within my existing IT infrastructure?

Yes. Usually implementation can occur fairly quickly.  DenteMax provider and fee data is fairly simplistic and integrates well with most IT platforms.

How long does it take to integrate the DenteMax network?

The majority of dental benefits plans can be integrate in 60 days or less. DenteMax can also work with you to address any special requirements that you might have.

What reports should we be using to sell dental?

DenteMax offer a complete suite of reports and analytic tools free of charge.  Please feel free to reach out to our account managers for advice in this process.

What do we need to obtain to begin market analysis?

Analysis usually begins with identifying member access and disruption which involve claims and census data. Please feel free to reach out to our account managers for advice in this process.

Should we automatically add the Medicare network at the same time I add the commercial network?

This is something that needs to be considered since the filing process is a little more complex. Please feel free to reach out to our account managers for advice in this process.

What do we need to begin customized recruiting?

The most important information a client partner can provide in a custom recruitment effort is a list of dentists the membership is using, with the dental office phone numbers.  In addition, use of the group name in the recruitment effort increases the success rate of the overall campaign; dentists recognize group names and will join the network based on group name recognition.  Please feel free to reach out to our account managers for advice in this process. One of DenteMax’s biggest advantages is our ability to customize and grow our network to meet your needs.

State of the Dental Industry
How many people in the United States lack dental benefits?

More than 132 million children and adults still lack dental benefits coverage that roughly 43% of the overall population.
NADP/DDPA Joint Dental Benefits Report: Enrollment, August 2012.

How many Americans visits a dentist in a year and how much do they spend?

In 2008, Americans made about 500 million visits to the dentist, and an estimated $102 billion was spent on dental services.
CDC "Oral Health: Preventing Cavities, Gum Disease, and Tooth Loss," 2009.

Only four cents out of every dollar spent on health nationally is spent on dental - that's less than half of what is spent on prescription drugs.
National Health Expenditures Projections 2009-2019, Centers for Medicare and Medicaid Services, 2009.

What is the overall value of the Dental Insurance Market?

The Dental Insurance Market was valued at $38.6 billion in 2010.
2011 NADP/DDPA Enrollment Report and 2011 NADP Premium and Benefits Utilization Report

How many people have medical insurance as opposed to dental insurance

Although almost 85 percent of the total population have medical coverage, only 57 percent of the total population have dental coverage.

For every person without medical insurance, there are approximately 2.8 people without dental insurance.
NADP/DDPA Joint Dental Benefits Report: Enrollment, June 2009.
U.S. Census Bureau, "Income, Proverty, and Health Insurance Coverage in the United States 2008," September 2009
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What is the most commonly reported individual health-related service not received because of cost?

Dental Care
U.S. Department of Health and Human Services, "Health, United States, 2008, With Special Feature on the Health of Young Adults," March 2009.

How often do people visit their dentist?

Eighty-one percent of individuals with dental benefits reported seeing a dentist twice a year or more, while only 34 percent of uninsured individuals reported the same frequency of seeking preventive care.
The Long Group Retail Dental Insurance Consumer Acceptance Survey, June 2009.

Is the marketplace trending towards Dental PPOs products for commercial dental benefits?

Dental PPO's have gone from 39% to 74% from 2001 to 2010. This represents the largest plan type avaliable.
2011 NADP/DDPA Enrollment Report

Are most dentist participating in Dental PPOs?

At the end of 2010, NADP found that most dentists are participating in dental plan provider networks. According to the American Dental Association there are 181,709 professionally active dentists in the United States and 116,978 are participating in a Dental PPO.
NADP 2011 State of the Dental Benefits Market

Are wellness programs like dental health care cost effective?

Did you know for every $1 spent on wellness programs, an employer can expect anywhere from $3 to $4.50 in return.
The Wellness Councils of America

What is the precentage of enrollees reaching or exceeding their annual maximum?

Only 5.5% of in-network dental PPO enrolless reach their maxium.
NADP 2011 State of the Dental Benefits Market