Baytown Texas Dentistry
Dr. Zach Holder and
Dr. Jesse Kirkpatrick

What is UCR, and how is it determined?

First, it’s important to understand that dental insurance isn’t really strictly insurance because it doesn’t actually cover the cost of a loss. Dental insurance is more like a monetary benefit provided by your employer to assist in paying for routine dental treatment.

Each employer selects a plan based on the amount of benefits and the monthly premium cost. Most benefit plans are designed to only cover a portion of the total cost.

UCR (Usual, Customary, and Reasonable) describes the maximum amount an insurance company will allow for a particular dental procedure. Unfortunately, some confusion arises because usual, customary, and reasonable doesn’t really mean exactly what you may think it means. UCR is simply a listing of payments associated with covered procedures. There really isn’t a standard formula or method for determining the UCR, and it isn’t related to the fee that our office charges for a particular service. 

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