Dental reimbursement / TERM EXPLAINED
Allowed Amount
The amount a dental plan recognizes for a covered service under its applicable benefit and payment rules; it is not automatically the amount the plan pays.
A dental practice example
A crown has a $1,200 charge but a $790 allowed amount under the participating fee schedule.
Why it matters for reimbursement
Separate patient responsibility from plan payment before assessing performance.
What to verify
Compare the contracted allowance, actual remittance and plan design for the same CDT and network.
FROM DEFINITION TO DECISION
Turn reimbursement questions into evidence.
PayorMap helps dental groups connect disclosed negotiated rates, provider and network context, and contract details to meaningful benchmarking questions. Coverage and mapping confidence vary by payor and market.