Capitation Fee--A fixed monthly allowance paid to a participating dentist by a Dental Health Maintenance Organization (DHMO) for each patient assigned to the dentist. The dentist uses this pre-paid fee to cover the costs of providing patient care.

Dental Health Maintenance Organization (DHMO)--A pre-paid dental care plan in which patients receive care through a group of dentists who are either salaried employees of the DHMO or who are under contract to the DHMO and receive compensation based on a capitation fee arrangement.

Direct Reimbursement--A method of providing benefits through which an employer reimburses employees directly for their dental care expenses instead of purchasing insurance coverage from a third party.

Fee for Service--An arrangement under which the dentist is paid for each service rendered according to a fee schedule established by the dentist.

Least Expensive Alternative Treatment (LEAT)--A limitation, found in most plans, which reduces benefits to the least expensive of all possible treatment options. Patients choosing the most optimal treatment plan may incur significant out-of-pocket expenses.

Point of Service Plan (POS)--A managed care plan that allows patients to seek treatment from a non-participating dentist (out of network), but at substantially lower benefit levels.

Preferred Provider Organization (PPO)--A plan in which an insurance company negotiates fees with dentists and directs patients to those dental offices. Patients who receive treatment outside of the dentist network pay higher co-payments and/or deductibles.

Table of Allowances--A method used by insurance companies to determine what fees they will alllow the dentist to charge. Unlike a UCR table, the Table of Allowances states a specific dollar figure allowed for each procedure.

Third Party Administrator--A firm that processes claims for self-insured dental plans.

UCR Percentile--A value on a scale of 100 that indicates the percentage of dentist whose regular fees are considered usual, customary and reasonable by an insurance carrier. For example, a fee covered at the 80th percentile would equal the fee charged by 8 out of 10 participating dentists in a particular geographical area.

UCR Schedule--A listing, developed by an insurance company, of maximum reimbursements allowed to the dentist for covered services, usually based on a UCR (usual, customary and reasonable) percentile of providers' fees within a defined area.