15 doctors weighed in:

How can I find a dentist that will accept my hmo as full payment?

15 doctors weighed in
3 doctors agree

In brief: Contract

Your hmo/dmo has a contract with various providers.
These providers have agreed to treat you at a specific, reduced fee. That reduced fee includes copayments from you. This is the agreement your employer has with the insurance carrier and your dentist.

In brief: Contract

Your hmo/dmo has a contract with various providers.
These providers have agreed to treat you at a specific, reduced fee. That reduced fee includes copayments from you. This is the agreement your employer has with the insurance carrier and your dentist.
Dr. Theodore Davantzis
Dr. Theodore Davantzis
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Dr. James Wright
Dentistry
3 doctors agree

In brief: Not possible

An hmo gives a dentist such a little fee that it does not even cover the cost of the procedure, the materials, and sterilization of the instruments in most instances.
The way a dentist is paid in a hmo network is by the number of people who sign up. The amount you are being charged is only available to you due to other people who signed up and did not come in for dental care.

In brief: Not possible

An hmo gives a dentist such a little fee that it does not even cover the cost of the procedure, the materials, and sterilization of the instruments in most instances.
The way a dentist is paid in a hmo network is by the number of people who sign up. The amount you are being charged is only available to you due to other people who signed up and did not come in for dental care.
Dr. James Wright
Dr. James Wright
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1 comment
Dr. Christine Fox
If a dentist accepted the HMO payment as full payment for the procedure, he/she would go out of business in a matter of months. No dentist can keep their doors open with such little reimbursement.
Dr. steven Present
Dentistry
2 doctors agree

In brief: You won't

Dentists that are part of an hmo are obligated by their contract to charge the stated co-pay if there is one.
If they don't they are committing insurance fraud.

In brief: You won't

Dentists that are part of an hmo are obligated by their contract to charge the stated co-pay if there is one.
If they don't they are committing insurance fraud.
Dr. steven Present
Dr. steven Present
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Dr. James Anderson
Dentistry
1 doctor agrees

In brief: HMO

Ask your hmo for a list of preferred contracted providers.

In brief: HMO

Ask your hmo for a list of preferred contracted providers.
Dr. James Anderson
Dr. James Anderson
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Dr. Marielaina Perrone
Dentistry - Cosmetic
1 doctor agrees

In brief: Need to contact

Your insurer with a list of providers that accept your insurance.
That would be the best resource for you.

In brief: Need to contact

Your insurer with a list of providers that accept your insurance.
That would be the best resource for you.
Dr. Marielaina Perrone
Dr. Marielaina Perrone
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Dr. John Francis
Dentistry - Periodontics

In brief: Fraud

Hard to imagine, but that is insurance fraud.
Your hmo has agreed to pay, let's say 90% of the fee. If they pay $90 and the dentist waives off the $10, really all you were charged was $90, and the insurance paid more than they should have.

In brief: Fraud

Hard to imagine, but that is insurance fraud.
Your hmo has agreed to pay, let's say 90% of the fee. If they pay $90 and the dentist waives off the $10, really all you were charged was $90, and the insurance paid more than they should have.
Dr. John Francis
Dr. John Francis
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Dr. Arnold Malerman
Dentistry - Orthodontics

In brief: Ask HMO for list

Hmo (dmo for dentistry) should have list of providers.
Ask your insurance company for list. There may be a copay. Insurance was supposed to be hedge against catastrophic loss, not cradle-to-grave nanny state. If practitioner agrees to accept reduced fee plan they must reduce cost of doing business, which means compromise in level of care.

In brief: Ask HMO for list

Hmo (dmo for dentistry) should have list of providers.
Ask your insurance company for list. There may be a copay. Insurance was supposed to be hedge against catastrophic loss, not cradle-to-grave nanny state. If practitioner agrees to accept reduced fee plan they must reduce cost of doing business, which means compromise in level of care.
Dr. Arnold Malerman
Dr. Arnold Malerman
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