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PPO Frequently Asked Questions

How is my office reimbursed on a PPO plan?

You are reimbursed on a fee-for-service basis. By submitting a standard ADA claim form or electronic claim, CompBenefits will process your claim according to your PPO fee schedule.

How much control will I maintain in the treatment of patients?

CompBenefits relies on your judgement when treatment decisions are made. Our relationship with you is based on a regard for your professional expertise and provides you ample freedom for referring your patients to specialists or performing procedures that allow you to provide quality care for your patients.

Do I have to participate with all CompBenefits plans?

You are free to choose which plans are the best for your office. We realize that some plans may not fit your style of practice management.

What are the qualifications of your participating dentists?

Participation in CompBenefits's PPO plan is contingent upon your passing our credentialing process. Each participating dentist is verified through a process designed to ensure the quality and integrity of CompBenefits' reputation, as well as to maintain a good reflection on your practice. Completion of a W-9 form, Practice Profile, Provider Application, and PPO Agreement are needed begin the credentialing process.

How often does the plan update their PPO reimbursement schedules?

CompBenefits Corporation reviews their PPO reimbursement schedules on an annual basis to ensure that the reimbursement to our participating dentists remains competitive.

What services are covered under CompBenefits's PPO plan?

The services covered by CompBenefits's PPO plan are defined under the Covered Patient's group dental benefits plan. You may contact Customer Care for details concerning coverage, exclusions, and limitations.

How can I find out if a patient is eligible for coverage?

CompBenefits provides access 24 hours a day, seven days a week via an interactive voice response system. By simply pressing keys on your touch-tone phone, the IVR system will let you know if the PPO patient you are treating is currently covered. If the dentist chooses, he or she may also contact our Customer Care Department during normal business hours.


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