A UCR or Usual, Customary, and Reasonable ( UCR ) Fee is the maximum amount of money that an insurance company will pay for a dental procedure. If a dentist charges two million dollars for a filling, the dental insurance company will only pay the maximum allowed.

          Most patients believe that a UCR is what is usually charged by dentists, what is customary for most dentists to charge and what is a reasonable charge for what was done.     No !

          The UCR is what the insurance company decides to pay.

          UCR is the name the insurance gives their payment.

          Different insurance companies have different UCR s.

          Using the name UCR is nice for a dental insurance company because the dental insurance company makes the patient think that the dentist is overcharging. The patient never thinks to ask if their insurance company is underpaying!

          When a patient gets into a financial fight with their dentist because their dental insurance company mislead the patient, the patient sometimes stops going to the dentist. However, the dental insurance company still collects their monthly premiums and doesn't have to pay out anything. Misleading a patient can mean bigger profits for an unfair dental insurance company.

          The dental insurance company can base its UCR on what a rural dentist is charging in an underdeveloped area and not what is normally charged in a big city. The city dentist has to pay more for rent, more for employees, and more for most costs. Patients who live in the city can end up paying more out of their own pockets because of their dental insurance company's questionable practices.

          Dental insurance companies often send damaging letters to patients stating that a dentist charges more than the UCR. These letters give dental patients the idea that their dentist is bad and not the dental insurance company. In August 2001, the ADA announced that it began a class action lawsuit against several dental insurance companies because of their manipulations which destroy dentist/patient relationships.

          The patient who fights these unfair practices can win but very few patients are willing to put the time in to argue with their dental insurance company about these unfair UCR s.