Dental Insurance Facts
If you belong to a traditional insurance plan, we can assist you by gladly filing your insurance claim for you. Traditional insurance is typically one in which you chose any dentist you desire. Our practice does not belong to any PPO or DMO insurance plans. If you are not sure what type of plan you have, we will be happy to call for you and explain your benefits to the best of our ability. It is important to realize that you are responsible for your dental treatment, as well as the fees incurred. Your insurance is a benefit that MAY help you with the financial obligation.
In an effort to provide high quality dental care and to clarify our position on filing for your insurance benefits, we would like to share some facts about dental insurance with you. It is important to understand that dental insurance is based on a contract between your employer and the insurance company. We will gladly estimate your dental benefits to the best of our ability, with the understanding that this is ONLY an ESTIMATE. The financial obligation becomes your final decision, regardless of what your insurance may or may not cover. We have a great deal of information regarding most insurances, but for delays in payment or coverage questions, it is best to call your insurance company directly. You might receive notification from your insurance company stating that our dental fees are “higher than the usual and customary fees”. Insurance companies survey the surrounding dental offices and average those rates to acquire “customary fees” for that area. This survey typically includes discount clinics and managed care facilities, which will bring down the average when compared to private practices. Many plans tell participants that they will be covered “up to 80 or 100%, but do not clearly specify plan fee schedule allowances, annual maximums or limitations. Insurance companies DO NOT cover all dental services. We have experience with a multitude of companies, and we keep track of the payment schedules for many of them. Our staff can estimate your insurance coverage at each visit and ask you to pay the difference each visit, unless previous arrangements have been made.
Some of our patients wonder why we are not on a preferred provider list which would allow for less out of pocket expenses for our patients. The health care field has undergone major changes in the last 5-10 years, and is effecting the way health care is provided. There are many plans that are being promoted that restrict your choice of doctor to those on a specific list at participating offices. The participation agreement between those plans and the providers usually requires the provider to discount care to those patients covered by that plan.
One of our top priorities is quality care. We incorporate the best materials, dental labs, techniques, a highly trained staff, and other supporting companies in order to deliver this high level of quality to our patients. We certainly appreciate value, but we are not willing to compromise our level of quality. The high number of referrals we receive from our patients is indicative of their appreciation for this this high level of care and service. Insurance companies do not monitor this level of service which can vary from office to office significantly.
Your insurance company will encourage you to use a “Preferred Provider”. Why are they preferred? These dentists have agree to reduce their fees in order to receive a higher number of patients. In order for these dentists to create a profit, most of them will need to use less expensive materials, foreign labs, and a less qualified staff. The result can often be compromised dentistry, that may need to be redone sooner than necessary.
We do not participate in any plan that encourages us to cut corners with a higher volume or to compromise the quality of care that you receive. The manner that our service is provided and the attention to detail is what makes all the difference. These are the values that our committed patients have come to honor and respect.