What does PPO provider mean?

A type of medical plan in which coverage is provided to participants through a network of selected health care providers, such as hospitals and physicians. Enrollees may seek care outside the network but pay a greater percentage of the cost of coverage than within the network. (Source: CDC)

A dental PPO provider is a dental professional or facility that has a contractual agreement with a dental insurance company to offer services to members of that PPO (Preferred Provider Organization) at a discounted rate. By choosing a PPO provider, patients typically receive lower out-of-pocket costs, but they also retain the flexibility to see other dentists, in-network or out-of-network, though at a higher cost. 

Key characteristics of a dental PPO provider:

• Contracted Network:

  They are part of a network of dentists selected by the insurance company. 

• Discounted Fees:

  They agree to provide services to PPO members at pre-negotiated, lower rates. 

• Cost Savings:

  When you see a PPO provider, you benefit from lower out-of-pocket costs, such as reduced coinsurance or copays. 

• Flexibility:

  While in-network providers offer the best savings, you can still visit a dentist outside the network, though you'll pay more. 

How it benefits you:

• Cost Savings:

  You save money by getting a better deal at an in-network provider. 

• Choice:

  You still have the freedom to choose your dentist, whether they are in or out of the network. 

• No Referrals Needed:

  You can typically see a specialist without needing a referral from a primary care dentist. 

• Quality Assurance:

  Participating dentists often undergo a rigorous review process by the insurance company. 

(Source: ADA)