Types of Dental Insurance
Yes our office accepts assignment of benefits from most traditional indemnity plans, however we are not in-network providers for any PPO’s or HMO’s. The three most common types of dental insurance are traditional indemnity plans, Preferred Provider Organizations (PPO’s), and Health Maintenance Organizations (HMO’s).
Assignment of Benefits
You are authorizing the insurance company to send your benefit amount directly to our office. You will be asked to provide us with basic information about your dental policy. We enter this information into our computer and will estimate the amount that your plan is expected to pay. You are responsible for paying your estimated portion at the time of service. If your plan does not cover all of the estimated amount then your account will have a balance due. You are responsible for this balance at the time the insurance check is issued or received.
Insurance Coverage
No insurance plan is intended to cover all of your dental costs. Most plans pay a percentage of pre-determined payment limits for each treatment. The limits that the insurance company sets (called UCR), are usually lower than the actual fee for that procedure.
Know Your Policy
Your employer or insurance agent has provided you with your policy and a booklet detailing your benefits. Find out who to contact within your company to help you with the finer details of your specific plan. We can help you with general questions, but due to the privacy act we may not have access to specific aspects of your plan.
Decisions on Treatment
Most patients choose the treatment that is best for them by understanding what their insurance plan covers and making other financial arrangements for the treatment that is not covered by insurance. Sometimes dental work can be done in phases in order to maximize your annual benefit allowance. It is seldom a good idea to let dental coverage limits dictate your treatment. The insurance company does not have your best interest in mind when it comes to oral health. Insurance companies exist to make a profit and their profit is better when you don’t utilize dental services.
Pre-determination
If you need to know in advance what your policy will pay then a pre-determination can be submitted to the insurance company. Please request this service if this is important to you in making your treatment decision. Some companies make this mandatory if treatment is over a set amount.