Frequently asked questions
| Who is DRC? |
Dental Risk Company (DRC) is a registered managed care organisation that specialises in managing a medical scheme's dental risk. DRC was established in 2001 and has grown from strength to strength over the last eight years, and currently administers dental benefits for more than 35 different scheme options. The members of these medical schemes are referred to a Network of approved dental service providers for any dental care that they need. Should you have dental queries you are welcome to contact our call centre at 086 111 5057 and an agent will be glad to assist you. If you prefer to communicate via e-mail you can address any queries to claims@dentalrisk.com. |
| How are benefits determined? |
It is important that you should know how your plan is designed. Should your plan specify that you have to make use of a Network provider, and your dentist of choice is not part of the Network, you will completely lose your benefits. You will also not be reimbursed by your medical scheme if you pay for the service out of your own pocket. |
| How do reimbursement work? |
Should you pay out of your own pocket when you go to a Network provider, you have to complete a reimbursement form and submit the form with a fully specified account, and proof of your payment to Dental Risk Company. Post your claim to Dental Risk Company, P 0 Box 7824, Centurion, 0046. |
| Where do I get a reimbursement form? |
You can obtain a claim form by contacting our call centre at 086 111 5057. |
| Can I use my own dentist I've been using for years or do I have to make use of a network provider? |
| You can make use of a dentist of your choice, but if your plan does not allow for you to go to a non-network provider, you will have to pay out of your own pocket and will not be refunded, even if you complete a reimbursement form. |
| What is the NHRPL? |
NHRPL stands for the National Health Reference Price List. The NHRPL encourages greater transparency between doctors and specialists. With the NHRPL, you will know in advance how much a particular consultation or procedure will cost. It creates an average reference price for doctors and specialists, and therefore an overall pricing guideline for patients. |
| What is a co-payment? |
Co-payment is a portion of cost for which you are responsible should your dentist charge more than the rates listed in the NHRPL. Exceeding your plan's fee, however, does not mean that your dentist has overcharged for the procedure. |
| How do I submit a dental claim? |
When using a Network dentist, you do not have to submit an account because the provider will handle the submission of claims for you. Claims that you need to submit yourself for any reason can be sent to our postal addres: Dental Risk Company, P 0 Box 7824, Centurion, 0046. |
| Are there advantages of using a network dentist? |
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Are there advantages of using a network dentist?
A. A Network dentist agrees to charge pre-negotiated prices which will save you and your medical scheme money. They will also submit the claim on your behalf. |
| What if I need recommended treatment that my plan will not cover? |
You need to make sure of exclusions in your plan. Payment for this treatment is then made by you directly to the dentist, and will not be refunded. You should be aware of the limitations in your plan but should not let these limitations stop you from having necessary treatment . |
| I received an account from my dentist that says I owe part of the charge, however my dental plan says that I am covered 100% for checkups and cleaning? What is this difference? |
Your plan pays a set rate. Although you can have consultations and cleanings, they have to be within a certain time period. Should you be uncertain about your plan’s benefits, you can contact our call centre and one of our consultants will gladly assist you. You can also visit the benefits page on this site, to confirm what is covered by your scheme. |
| What do I need to do when services need pre-authorisation? |
You need to get certain services and procedures authorised by the DRC – call us on 086 1115057. If you do not get pre-authorisation for these procedures before you have them done, you will be expected to pay a penalty. Please remember that a pre-authorisation is not always a guarantee that the procedures will be paid for. Pre-authorisation means that the procedures are clinically acceptable and will be paid, provided that you still have sufficient benefits available and that your membership is active when this service is rendered. |
| What is basic dental care? |
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| How can I find a Network provider in my area? |
| Click here
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