DENTAL INSURANCE

Dental insurance plays a large role in helping people obtain dental treatment. Since we strongly feel that our patients deserve the best possible dental care we can provide, and in an effort to maintain the high level of care, we would like to share some facts about dental insurance with you.

FACT #1: Dental insurance is not meant to be a PAY-ALL, it is only meant to be an aid.

FACT #2: You may receive notification from your insurance company stating that dental fees are higher than usual and customary. An insurance company surveys a geographic area, finds the average fee, and then takes 90% of that fee and considers it customary. Included in the fee survey are discount clinics and HMO/PPO practices which will bring down the average. Any doctor in private practice will have fees that are considered higher than average.

FACT #3: It has been the experience of many dental practices that some insurance companies tell their insured that "fees charged are above the usual and customary fees" rather than admitting "our benefits are low". Please remember that the amount your plan pays is determined by how much you or your employer paid for the plan. Basically, the amount of benefits you receive depend on the amount of premiums paid minus the profits of the insurance company.

FACT #4: Many plans tell their insured that they will be covered "up to 80% or 100%" but do not clearly specify plan fee schedule allowance, annual maximum or limitations of procedures that are covered. In some plans, many routine dental services are NOT covered by insurance carriers.

We are NOT contracted with any insurance companies and we are NOT members of any plans. Some HMO or PPO plans will allow their insured to receive some benefits if they elect to go "out of network". It may be necessary for you to contact your insurance company or your employer regarding the specifics and details of your plan. We will be glad to file your insurance claim and assist in helping you receive allowable insurance benefits. However, the patient is ultimately responsible for any balance incurred in our office, not the insurance company.

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