How do PPO dental plans compensate providers for standard dental procedures?

• A. Capitation
• B. Prepayment
• C. Reduced fee schedules
• D. Usual and customary fees

Answer: (C)

PPO dental plans compensate providers with reduced fee schedules—participating dentists agree to a discounted rate as payment in full for covered procedures. This negotiated discount is built into the plan and is how network providers are paid, helping keep costs down for members. Capitation would pay a dentist a fixed amount per member regardless of services, which isn’t how PPOs reimburse standard procedures. Prepayment isn’t the standard method for these plans, and usual and customary fees describe what a non-network provider might charge or how reimbursement is determined in non-network scenarios, not the negotiated payment rate for in-network providers.