Q: What is a DMO (Dental Maintenance Organization)?

A: A DMO is a discount fee plan for dental treatment. The DMO requires each insured member to designate a dental service provider. Therefore if a patient wants to come to SDA, they need to call their plan office and tell them they want SDA as their provider. The fees that each provider charges are listed on a fee schedule prepared by the DMO. The fees are the same regardless of which dental office the patient visits.

Q: What is PPO (Preferred Provider Organization) insurance?

A: The patient's insurance company sets the fees that PPO dentists may charge. To be a “preferred provider”, a dental office must agree to charge the designated fees. Unlike the DMO patient, a patient with PPO insurance is not required to designate a provider. However, the patient must see a “network” provider to be eligible for the PPO fees. SDA is a network provider for most PPO's.

Q: What is a traditional or indemnity insurance?

A: It is an insurance plan that allows the patient to select any dental office they want. The insurance company pays a percentage of SDA's fees for the services provided. The patient pays their deductible plus any portion of our fees not covered by insurance.

Q: Why can't SDA call the DMO and assign the patient to one of our offices?

A: The DMO will only allow the patient to call and select a provider for themself. We as a provider may not call the DMO and designate our office for the patient.

Q: For the DMO patient, why can't the patient go to any Southern Dental office?

A: The DMO assigns each office a unique facility number. If the patient designates one
of our offices as their office of choice, but later decides to go to another SDA office, the DMO will not cover the patients' visit. Therefore, the patient must go to the
office in which they are assigned. However, if they want to switch to another SDA
office, the patient must call the DMO and ask them to switch the patient to the new location.

Q: Why can't patients use two DMO plans together?

A: A DMO plan is a discount fee plan. Therefore, patients can not use two discount plans for the same service. For example, people can not use two coupons for the same item at the grocery store. A patient must chose one DMO plan for their family. They can not use both plans.

Q: Why can't patients use a PPO and DMO plans together?

A: Both types of plans have their own fee schedules. The patient must choose which one they wish to use.

Q: How much will certain types of treatment cost under their DMO or PPO plan?

A: The patient may get a general idea of the cost by referring to their plans fee schedule. However, until the patient has been examined by one of our Doctors, no fee is definite. SDA always discusses fees and financial arrangements before any treatment is started.

Q: What is the name and phone number of my insurance company? Isn't your computer hooked up with the insurance companies computer?

A: The patient should obtain this information from their employer, then give the
information to SDA.

Q: What is a co-pay and what is a deductible? What is my cost when I come in for my appointment?

A: A patient's co-pay is the amount the DMO patient is required to pay for each dental procedure. The co-pay amount is determined by the DMO fee schedule. A deductible is the annual amount which is not covered by indemnity or PPO insurance. The deductible is the patients responsibility

Q: Why do we not accept medicaid for braces?

A: Medicaid does not pay for routine orthdontic care. The type of orthodontic treatment covered by medicaid is beyond the scope of our Orthodontist.

Q: Why is it necessary for DMO patients to have their name on a roster before they can be seen by the dental office?

A: DMO patients are assigned to a specific office. Unless a patient's name appears on the roster assigned to an office, we can not see the patient unless we charge our usual and customary fee.

Q: If I have either DMO or PPO, how much money do I have to bring with me on my first visit?

A: SDA accepts cash, check and four credit cards as forms of payment. Additionally, patients with approved credit may use a payment plan through CareCredit to pay for their treatment. Patients who wish to pay for their services with cash should alert a SDA staff member to limit the amount of treatment to the amount of available cash at each visit.