The Role of Dental Insurance in Our Practice
Being an insurance network provider would not allow us to do that.
Many of our patients have dental insurance which covers a portion of the fees for quality dental services. While most of us have medical insurance policies that evolved from “major medical” insurance, dental insurance plans always have a schedule of fees, based on the average in your area, as well as an annual cap on the maximum reimbursement. All insurance companies have different reimbursement allowances based simply on what the employer negotiates with the insurance company.
Strictly speaking, dental benefits are merely an aid to help lower the cost of care. In fact, many routine dental services are NOT covered by insurance. While many companies tell patients that they are covered from 80 to 100%, due to fee schedules, waiting periods, and other fine print limitations, it’s more realistic to expect 25 to 60% coverage for selected services.
That said, your insurance CAN be used here. We’ll submit the claim for you, along with any necessary documentation, and they will reimburse you.
We do not file any predeterminations because we have experienced too many inaccuracies and false expectations. We will do our best to estimate your coverage, but keep in mind it is only our best guess and you will be held responsible for any services provided that your insurance does not cover.
Ultimately, your policy is a contract between you and your provider (and, as applicable, your employer). We’ll do our best to help you, but it’s up to you to understand your benefits.
We value the relationships and trust developed with our patients and will always provide you with the finest possible care without regard to any limitations of your insurance.
We have many patients who choose our practice despite what their insurance tries to tell them to do.
For additional information, please read this letter regarding our doctors’ explanation of dental insurance and dental “marketplace.”