Ethics & Law · single question

Which dental benefit plan typically reimburses the PATIENT directly (patient pays the dentist, then is reimbursed)?

Indemnity (traditional fee-for-service) plan
DHMO / capitation plan
Preferred Provider Organization (in-network)

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Correct answer: A. Indemnity (traditional fee-for-service) plan

Indemnity/direct-reimbursement plans reimburse the patient directly. (The recall sheet's PPO note refers to out-of-network reimbursement; the textbook 'patient reimbursed directly' answer is the indemnity plan.)

A. Correct. Indemnity/direct-reimbursement plans pay the subscriber directly based on submitted claims, leaving dentist choice unrestricted.
B. Capitation pays the contracted provider a set fee; the patient is not reimbursed directly.
C. In-network PPOs generally pay the contracted dentist directly, not the patient.

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Which dental benefit plan typically reimburses the PATIENT directly (patient pays the dentist, then is reimbursed)?

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