About Your Insurance
Insurance can be a complicated and mind-boggling thing. Dealing with it and trying to understand it may be worse than the actual dental experience (we know, wishful thinking). The purpose of this section is to hopefully make it easier to understand the basics and let you know how we can help with the headache.
Being a provider for your insurance company means that we have negotiated with the company a discount off of our regular fees. This benefit comes as a result of the premiums you pay each month to the insurance company. Also, your insurer, whether that be your employer or yourself, negotiates percentages that the insurance company pays for certain types of procedures. For instance, for routine cleanings and X-rays, many insurance companies pay 100% of the agreed-upon fee because it is considered preventive. For procedures such as fillings or extractions, your insurance may cover just 80%, and for more involved procedures like crowns, bridges, and dentures it may only pay 50%. What this means is that your insurance company pays a portion of the discounted fee and you are responsible for the remaining portion. Our office has no control over these percentages and contractually must honor them.
Where we can help is in submitting claims in a timely manner (usually the sameday) and only requiring your portion at the time of service. We will then wait for the insurance company to pay its portion, keeping you from having to pay everything up front and waiting sometimes weeks or months to get reimbursed. Our goal is to make this confusing and sometimes frustrating process easy and efficient.
Another way we try to help is by calling your insurance company while you are here for your first visit and verifying that you do have coverage and what exactly your benefits include (you might be surprised how often there is a mistake with the insurance company or your employer’s HR department, which we can easily clear up). In this way we can give you accurate estimates for what your portion would be for any proposed treatment that day. Our front office staff is wonderful at answering your questions and helping you get the most out of your insurance.
If you have any questions regarding financing or insurance coverage, please contact us today.