Home Forums Practice Management Systems Understanding Insurance and PPOs Reply To: Understanding Insurance and PPOs

Brian Stoute

I am a bit unclear about Alternate benefit and downgrades.  From what I understand, the insurance company may reimburse for a lower cost procedure to the one that was actually performed. e.g reimburse for a partial denture, when a bridge was actually done.  From the above e.g. what is the patient's co pay based on? Is it the bridge that was done or the partial denture that was paid on.