Our insurance coordinators deal with many different insurance companies. Some companies offer many different dental and medical plans. These companies can change benefits, co-pays, and deductibles many times throughout the year. We do our best to provide you with accurate coverage estimates based on information available to us. At times, it is almost impossible to accurately estimate a patient’s insurance co-payment. Many insurance companies will not give out fees until after the treatment is completed. Dealing with these companies can be difficult and time consuming. As a courtesy, we ask that you keep us informed of any change to your insurance. It is important that all information about you and your insurance is current.
Although we are non-participating (“out of network”) with dental insurance plans, we will gladly file a claim on your behalf and do our best to maximize your benefit reimbursement. You may wish to submit the claim yourself. In general, insurers process claims filed directly by patients faster than those filed by the service providers (dental offices).
Furthermore, most dental insurance policies are limited and often only pay for a portion of the procedure(s) that may need to be done. We must emphasize that our relationship will be with you and not your insurance company.
How Dental Plans Work
Many dental plans are a result of a contract between your employer and an insurance company. The amount your plan pays is agreed upon by your employer with the insurance company. Your dental coverage is not based on what you need or what your dentist recommends. It is based on how much your employer pays into the plan. Plan coverage limitations may involve:
- Annual Maximums
- Pre-existing Conditions
- Plan Limits
- Least Expensive Alternate Treatment Provision (not always the best treatment option)
We will be happy to assist you in trying to learn about your plan and what can be done to maximize coverage for recommended treatment.