Direct Reimbursement Administrative Services, LTD.      
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How it Works

The following is an overview of why direct reimbursement is the most cost effective method to provide your employees with the highest quality of health care. With direct reimbursement, your company only pays only for the benefit it receives, and the cost to cover the expenses to organize and administer the plan. Here is how it works to save you money, and give your employees what they desire in a dental plan:

Direct Reimbursement Dental, Medical (HRA) and Vision Plans.

  • Employers can design the plan any way they want...customized and not off-the-shelf. The employer retains control.
  • Your employees have freedom of choice -- direct reimbursement, has the best network of dentists and physicians because it includes all dentists and all physicians!
  • You have a better dental and medical plan at less cost. This includes a rich benefit for the employee along with lower overhead for the employer.
  • Can include any dental, medical and vision care
  • Benefits are based on a percentage of a specified dollar amount up to an annual maximum.
  • Self-funded
  • Simple
  • User Friendly
  • No exclusions or limitations
  • No UCR
  • No predetermination
  • No claim forms
  • Employer receives the credit for providing the benefit; not some insurance company.

Direct Reimbursement Employee - Process.

  • Employee choose own dentist or physician.
  • Employee and health care provider determine treatment.
  • Employee incurs expense.
  • For medical HRA, employee submits medical insurance EOB. Dentist submits claim form as proof of treatment to DRAS, Ltd.
  • Employee is reimbursed by DRAS Ltd., from employers dental account.
  • Employee is responsible for paying dentist or physician.

Direct Reimbursement Employer - Process.

  • Claims are processed by DRAS, Inc.
  • A check register is emailed to company and funds are mailed or wired to cover claims.
  • Checks are written and mailed by DRAS.

Why Self-Funded Plans?

  • Dental costs are predictable, unlike medical costs.
  • No need to insure/manage costs that are non-catastrophic.
  • No need to insure/manage costs that are low-risk and low cost.
  • HRA when used with a high deductible medical insurance, are also predictable and non-catastrophic.

Overhead Compared

  • Indemnity/Insured 15% - 30%
  • HMO/DHMO 30% - 40%
  • Traditional/self-funded 9% - 13%
  • Direct Reimbursement 4% - 8%

What Employees want in a dental and medical plan.

  • Freedom of choice - to go to provider of choice, quality provider, ability to stay with family dentist.
  • User friendly - simply, no confusing handbooks, no UCR/limitations and complications.
  • Treatment decision between patient and provider.
  • Quick reimbursement/simplicity.
  • Assistance from employer in meeting dental and medical costs.
  • All dental procedures covered.
  • No exclusions for pre-existing conditions.
  • No long waiting for appointment for a network of providers.

Why Employers offer dental and medical benefits.

  • Requested by employees.
  • Popular benefit.
  • Encourages employees to seek routine dental and medical care.
  • Reduces absenteeism.
  • Increases employee loyalty.

Administrative Office
Direct Reimbursement, Adm., Services, Ltd.
P.O. Box 292455
Kettering, OH 45429
Tel: 937/428-1046
Fax: 937/428-4831
email: admin@DirectReimbursement.com

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