Frequently asked questions

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. Should you have dental queries you are welcome to contact our call centre at 086 1115057 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 or network@dentalrisk.com

It is important that Network providers know the benefits per option, which is why we supply a yearly operational manual. You can see each option’s benefit on this website. To find it, click here . A list of contracted schemes appears in alphabetical order. Choose the option you require and a drop down will supply a list of covered day-to-day benefits.

As a contracted network provider you have agreed to see members at the current NHRPL rate according to the protocol designed by the particular scheme. All codes covered must be claimed directly from DRC or the scheme and not in cash upfront from the member. Codes that are not covered are to be claimed directly from the member. The member should be informed of this and any associated costs before the procedure begins.

No, because the scheme benefits state that the benefit is only applicable for members who visit a contracted provider. Even if the procedure is a covered code like fillings or extractions, this is not covered as the member is disqualified from the benefit, because you are not contracted.

The standard rate for all network options is the NHRPL rate for that applicable year.

You can only charge a co-payment on procedures that are not covered by the option. Your agreement with DRC as a contracted provider states that you will claim according to benefits and pricing for covered codes, which is all basic dentistry items. Items not covered are to be negotiated privately between yourself and the member, before the procedure is performed.

All network options for CareCross are to be submitted to DRC directly. Liberty Titan and Platinum Complete options should be submitted to Liberty. For further information on this please send an email to claims@dentalrisk.com

DRC has over 430 000 lives under management, and most can only be seen by a contracted provider so we will increase your patient base. In addition to this, if you know the benefits and ensure that the member is still paid up with their scheme, payment is guaranteed – this should eliminate the problem of bad debt, provided you work within the scheme’s benefit guidelines.

More people through your practice, even if they are on the low-income options, can create a surge in the strongest form of advertising for your practice provided they receive excellent treatment. This word of mouth advertising will grow your practice even further.

Should you utilise time management correctly and pre book all consultations you will be able to fill your slower time periods in a given day, and thus improve your practice’s financial viability.

You need to additional procedures authorised by DRC by calling us on 086 111 5057. This is very important because members will pay a penalty it these procedures are performed without getting the necessary pre-authorisation in advance. Please remember that a pre-authorisation is not always a guarantee that the procedures will be paid. Pre-authorisation means that the procedures are clinically acceptable and will be paid, provided that the member still has sufficient benefits available, and the member is active when this service is rendered.

Consultations
Oral Hygiene
Fillings
Extractions
Emergency root canal treatment (please note a full root canal is not covered for any CareCross option)

The basic cover is quite comprehensive, but please be advised that clinical protocols apply at all times.

Click here for more information or email us on network@dentalrisk.com