A dental PPO pays a percentage of a negotiated fee and lets the patient see any dentist, with better coverage in network. A DHMO assigns the patient to a specific office and pays that office a fixed amount per patient per month, with the patient paying a set copay per procedure.
The distinction changes what the front desk has to check. On a PPO the question is coverage, remaining maximum, and frequency. On a DHMO the first question is whether the patient is actually assigned to your office, because an eligible patient assigned elsewhere is not a patient you can bill for.
It also changes the answer to the most common new-patient question. 'Do you take my insurance' means something different under each model, and getting it wrong on the phone costs either the appointment or the collection.
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Echo in action
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