Patient Insurance Questions

Patient Insurance Questions

IMG_0514We are often asked if we accept various dental insurance plans. We accept any insurance which allows the patient to see the dentist of their choice. If your plan requires you to see a specific panel or network dentist, you would not be covered here. To be certain, please check with your insurance company.

Our office is committed to helping you maximize your insurance benefits. We file dental insurance as a courtesy to you. We do not have a contract with your insurance company, only you do. The parent is responsible for the fees the insurance does not cover.

We do our best to give a close “estimate” of insurance benefits; however, we have no control over benefits paid. It is impossible to determine what each insurance company will pay, as we accept hundreds of insurance plans. Even when an insurance company states the coverage is 100%, frequently this is not so. Some insurances pay on a “fee schedule” meaning that they pay a percentage of a predetermined fee. This fee may be far below fees charged in this geographical area. Some insurance companies state “the benefit was reduced because your dentist’s fee has exceeded the usual, customary or reasonable fee (UCR)”. A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable, this is misleading and simply not accurate. Insurance companies set their own fees and each company has different “allowable” fees. Even various employers within the same insurance company have different allowable fees. This can be determined by the level of coverage the employer purchases.

Our doctors recommend services that are in the best interest of the child, not on what insurance companies cover. It is our primary goal and responsibility to help our patients obtain good dental health.

Please feel free to contact us if you have any additional insurance questions.