There is now an online resource that could help raise patient awareness about dental fees and insurance. Insurance Solutions reported in their June newsletter about the website, www.fairhealthconsumer.org, which is maintained by Fair Health, Inc., an independent non-profit organization.
Fair Health was established to provide unbiased fee and reimbursement information for patients. You can also find helpful information about a variety of insurance-related topics from how coordination of benefits works to how insurance plans set their allowable fees. And the website is easy to use and maneuver.
The website contains 65 CDT codes that comprise 95% of the most common dental procedures. When you visit the site, you simply enter your zip code and the procedure and you receive the fee and expected reimbursement from insurance.
According to the website, the fees are set at the 80th percentile, meaning the fees represent an amount at or below what 80% of dentists in a given zip code charge. Patients also have the opportunity to view fees at other percentiles, which is helpful when the patient has a dental plan that uses a lower reimbursement schedule.
The website is the result of a settlement between the New York Attorney General and Ingenix, a subsidiary of United Healthcare. The Attorney General’s investigation showed that Ingenix, which provided data to help many insurance companies set allowable out-of-network fees, intentionally skewed data downward.
In the settlement, United Healthcare agreed to fund the establishment of a new non-profit to run an independent database which now helps insurers set out-of-network reimbursement levels. And, Fair Health was created as another independent non-profit to help patients.
I encourage you to spend some time on the Fair Health website. Consider if your patients could benefit from using this resource.