The American Dental Association recognizes the important role dental benefits have played in improving access to dental care for millions of Americans and is working with insurance policymakers to help set better standards within the industry.

Under a UCR plan, patients are usually allowed to see the dentist of their choice. These plans pay an established percentage of the dentist fee or pay the plan sponsors customary or a reasonable fee limit, whichever is less. Although these limits are called customary, they may or may not reflect the fees that area dentists charge.

It may also be noted on your bill that the fee that your dentist is charging you is higher than the reimbursement levels of UCR. This does not mean your dentist is overcharging you; for example, the insurance company may not have taken into account up-to-date regional data to determine a reimbursement level. Why? There is no regulation as to how insurance companies determine reimbursement levels resulting in wide fluctuation. In addition, insurance companies are not required to disclose how they determine these levels the language used in this process may be inconsistent among carriers and difficult to understand.