Dental Benefits, PPO Dental Plans Balance Billing
Balance billing is when a dental office bills an enrollee for the amounts above the PPO payment and the enrollee’s coinsurance, If the dentist is within the PPO plan network of providers balance billing would generally be a violation of their contract with the PPO provider since the dentist within the PPO network agree to accept the PPO provider contracted fees and not the bill above that amount.
However it is important to note with most PPO plans you are able to go to dentist that are not in the plan network. Therefore if you choice to go to a Non-contracted dentist (out of network provider) they are under no such obligation to limit the amount of their fees.