What is PDP Plus network?

What is PDP Plus network?

The PDP Plus network was developed to improve consumer provider choice and access — we also concentrated on adding providers that enrollees are likely to visit. The goal was to deliver more network options to you and your enrollees, which can help lower out-of-pocket costs and better control plan costs.

Is MetLife PDP plus the same as PPO?

MetLife, a provider of dental plan administration for more than 21 million people, today announced the availability of a new, expanded Dental Preferred Provider Organization (PPO) network, PDP Plus.

What does PDP stand for in dental insurance?

Preferred Dentist Program
® Preferred Dentist Program (PDP) Overview.

Does MetLife pay out of network?

Annual Maximum Benefit *Reimbursement for out-of-network services is based on the lesser of the dentist’s actual fee or the Maximum Allowable Charge (MAC). The out-of-network Maximum Allowable Charge is a scheduled amount determined by MetLife † Applies only to Type B & C Services.

What does 90th percentile mean in dental insurance?

Plan Pays. If your plan pays up to the 90th percentile, this means that 90% of dentists in a given area charge that fee or less.

What does out of network 90th percentile mean?

The 90th UCR is typical for many of our plans. This means the UCR value for a given procedure will be set so that 90% of providers in your area charge that amount or less. This amount is the maximum Beam will pay for a covered service from an out-of-network provider.

What is PDP MetLife?

The MetLife PDP is a Preferred Provider Organization, wherein you choose a provider at the time of treatment. You do not have to pre-select a primary dentist nor do you need an ID card or referrals for specialty care.

What is R&C fee?

R&C fee refers to the Reasonable and Customary (R&C) charge, which is based on the lowest of 1) the dentist’s actual charge, 2) the dentist’s usual charge for the same or similar services or the usual charge of most dentists in the same geographic area for the same or similar services as determined by MetLife.

What is the difference between Mac and PPO?

MAC stands for Maximum Allowable Charge (and can sometimes be called a PPO Fee plan) and UCR stands for Usual, Customary, and Reasonable. Basically, these terms refer to the way that coverage is determined when you visit an out-of-network dentist.

What does 80th UCR mean?

UCR values are set at a level where 80% to 90% of local providers have charged that amount or less. Let’s make it simple: if your insurer’s UCR charge for a routine cleaning is $200 at the 80th percentile, that means eight out of every 10 dentists in your local area charge $200 for that same cleaning.

Which doctor is best for root canal?

If you need a root canal, see an endodontist, the specialist in saving teeth. Endodontists are specialists in saving teeth, committed to helping you maintain your natural smile for a lifetime.