PARTICIPATING DENTISTS
We have listed participating dentists by specialty and by county. Within each list, the dentists are ordered by zip and then by name. If there are too many names within in a Specialty/County group (for example, Philadelphia and General), the list will be subdivided further into sections of about 100 dentists per list. Please read the section below on using a participating dentist. We suggest that you check with the dentist to insure that they are still a participating dentist.
We now have listings for dentists who have joined since the last listing as well as those who have dropped.
Specialties:
Using a "Participating Dentist" Provides Protection
For their own benefit, members should strive to use participating dentists at all times. The most important benefit one receives when using a participating dentist is financial.
Let's use the example of two dentists who submit for a crown. One dentist participates and the other does not.
Participating dentists have agreed to accept United Concordia's allowance while a non-participating provider is permitted to charge whatever he wishes. Both dentists charge $695.00 for the crown, of which the plan will pay 50% or $348.00. The United Concordia allowance is $435.00, which means the participating dentist is entitled to $87.00, for a total of $435.00 which is the United Concordia allowance. The non-participating dentist would collect the same $348.00; however, the subscriber would owe $342.00 up to a total of $690.00 Use of a participating dentist saves the subscriber $342.00 for the identical services.
Our plan also requires that a pre-determination plan be submitted for certain services or any treatment which incurs a cost of $300.00 or more. A participating dentist who fails to submit such a plan for a claim which is subsequently rejected is not entitled to payment from the subscriber or the insurance company for the service. A non-participating dentist will bill you for any service rejected by United Concordia.
Participating dentists are forbidden from collecting any fees including co-payment until sixty (60) days after receipt of the Explanation of Benefits from United Concordia. A non-participating dentist is free to establish his own payment schedule.
In addition to the financial reasons for using a participating dentist, the Health & Welfare Fund has the ability to intervene in the event of a dispute which involves a participating dentist. A non-participating dentist is not subject to any influence from the Fund.