Determination of utilization in a dental insurance plan
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Citation
Abstract
The objective of this study was to determine and compare the dental care
utilization of 37,000 New England employees, insured by Empire Blue Cross Blue
Shield and Metropolitan Life insurance companies under dual option, preferred
Provider ( Closed) Plan and Open Plan.
This investigation was carried out by a random selection of 5,000 records of
insurees. Comprehensive statistical analysis was performed to evaluate dental
services provided through both dental insurance plans. Dental services were broken
down by the ADA Procedure Code classification and service mix statistically
examined in relation to Plan type ( Open, Closed), claim administrator (Empire,
MetLife) and eligibility type (Employee, Spouse and Dependent).
This sample comprised of members (employees), their spouse and
dependents who, overall, formed a group of 2064 (41.3%) males and 2936 (58.7%)
females. Of the total 5000 dental claims filed 1929 (38.6%) were through the Open
Plan and 3071 (61.4%) through the Closed Plan. Specifically, for each dental
procedure claims were counted with either Plan type.
Description
Thesis (M.Sc.D.)--Boston University. Henry M. Goldman School of Graduate Dentistry, 1990 (Public Health Dentistry)
Bibliography: leaves 39-40.
Bibliography: leaves 39-40.
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This work is being made available in OpenBU by permission of its author, and is available for research purposes only. All rights are reserved to the author.