Dental
insurance is a highly complex area that creates confusion for many
dental patients. The complexities of dental insurance and the lack
of sufficient information provided by some insurance companies make
it almost impossible for some patients to properly understand their
benefits. Even more confusing is understanding how to properly work
with your dental insurance company to achieve the highest level of
benefits to which you are entitled.
What
is Dental Insurance?
Dental insurance is a contract between your employer and a
dental insurance company. The benefits that you will receive are
based on the terms of the contract that were negotiated between
your employer and the dental insurance company and not your dental
office. The goal of most dental insurance policies is to provide
only basic care for specific dental services. The services selected
are based on the cost of the policy to your employer and the negotiated
arrangements with the dental insurance company.
The
benefits that you receive from the dental insurance company
for your current insurance plan have nothing at all to
do with you or achieving a high quality complete result.
Because
the benefits you currently have are decided between your employer
and the insurance company, many services are not covered. The
selection of non-covered services is not based on what you
need or want, but is based strictly on the contract with the
insurance company.
This
is why so many dental patients become confused about dental
insurance. Dental insurance companies rarely cover 100
percent of any dental fee and, in many cases, cover less
than 50 percent or nothing at all.
Covered & Non-Covered
Services
Unfortunately, some of the services that you may need or want
will not be covered by your dental insurer. Our goal is to help
you achieve and maintain optimal dental care, which is not necessarily
the goal of your dental insurance company. The goal of the insurance
company is to provide only the negotiated benefits for the specifically
selected services.
The
reimbursement mechanism from your dental insurance company
is merely a mathematical formula as to which benefits you will
receive and the percentage of the dentist's office fee that
will be paid. We do not want to compromise your care based
on restraints placed by an insurance company.
Another
fact that most dental patients do not realize is that each
dental insurance plan has a dollar amount limitation each year.
Once this limit is reached, no other services will be covered
by your dental insurance company regardless of how essential
the service may be to your dental health.
How
Our Office Helps
Our office will do everything possible to help you understand
and make the most of your dental insurance benefits. We realize
that dental insurance is complex and that it is extremely difficult
to understand how to make it work or even to work with certain
dental insurance companies. That is why we provide full assistance
to you.
Our
office will complete and submit dental insurance forms to the
company to achieve the maximum reimbursement to which you are
entitled and will work diligently to make this happen as quickly
as possible.
Please
be aware that some dental insurance companies take longer than
others to complete payment. If necessary, our office will contact
the dental insurance company, or we may request your help in
this matter.
Pre-Determination
Policies
Many insurance companies try to control the amount of dentistry
you receive by requiring authorization for procedures in advance.
Our office will do everything possible to help you maximize the
insurance benefits to which you are entitled.
In
most cases, we can begin treatment prior to receiving an authorization
from the dental insurance company. However, patients need to
understand that in the event the dental insurance company refuses
to pay for treatment, you are responsible for all fees. Naturally,
we always provide you with the full fees in advance so that
you know the exact cost of treatment.
Like
you, we recognize that the authorization process is often time
consuming and unnecessary.
Elective
Treatment
Some services are typically not covered by dental insurance
companies. These include cosmetic dentistry, implants, occlusion
or bite redesign, and other services. Although these are important
dental services that can greatly enhance the quality of life of
our patients, dental insurance companies do not feel that they
should have to pay for these services. That is why these services
are rarely included in contracts with your employer.
Ask
Us for Help Any Time
Any time you have a question about your dental insurance, please
feel free to ask us. We recognize that dental insurance is becoming
more complex and more difficult to understand everyday. This is
often due to the quest by dental insurance companies to reduce
costs through continual changes. Keep in mind that the dental insurance
companies are not concerned about coverage for optimal dental care,
but provide coverage for only a limited number of basic services.
Our
Philosophy
Our office remains dedicated to providing optimal care for
every patient and working with you to achieve that goal. We pride
ourselves on helping you in any way and in continuing to provide
the quality of care to which you have become accustomed.
Please
let us know if you have any questions. It will be our pleasure
to help you.
|
