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Dental plan - capitation basis

R

rktc

Member
The notes explains that

"The capitation basis in where the insurer and dentist agree a sum per insured mouth. The insurer would receive regular fee, deduct the amount for its expenses and passes the remainder on to the destist. In return the dentist would provide treatment and bears the risk that cost of treatment required is more than expected. The insurer will deal with the administration of the arrangement but will often only cover the cost of accident and emergency treatment (eg. when away from home and unable to visit own dentist)"

Am I correct to say that the emergency treatment paid for by the insurer is an addition to the normal treatment which the insured is may receive from the dentist? Therefore, the detal plan would cover both emergency treatments and treatments under normal circumstances.
 
I'm sorry, I've only just seen your post - and I understand that the ST1 exam was yesterday - so this response won't be much use now!:rolleyes:

However, I agree with your understanding of how a typical plan would work. The dentist would not cover A&E work carried out by another dentist but the insurance would cover this, and so, yes, you'd be covered for both.

So even if this did come up in the exam, I hope you can be confident that your understanding is sound!

Hope all went well. Please, folks, do use the discussion forum to share your thoughts on the ST1 exam.

Regards
 
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