Dental insurance is a misnomer since it does not insure you against major dental issues like most medical plans. Instead they are discount plans. Our office has a normal list of fees we charge, and when contract with your insurance that effectively commits to their lower discounted fees. Yay you! Additionally, they can also act as a third party payor which means they will pay us, on your behalf, after the work is done. Sadly, we’ve learned that they can delay payment, ask for more information (again delaying payment), deny the service which permanently delays payment, and those payments will dry up as soon as you use up your limit which is generally around $1500. We work very hard to understand your individual plan so that we can minimize surprises.
Unfortunately, some plans are soooo low, we can’t afford to accept them, and many of those individuals will choose to NOT use their plan and purchase ours instead(please link to our in-house plan). Because there are so many plans out there, we suggest (1) study the list that your plan provides either online or in a booklet that shows all the doctors (providers) that have contracted with them. (2) Call us, and see if we have experience with your particular plan.
The secret to getting good results from your plan is to be familiar with it, call your plan provider, and ask them what-if questions. Take the name of the person you are speaking with, ask them how, and what documents are needed. And, remember their job is to make money from the money you and your employer gave them, so it’s in their best interest to minimize expenses- YOU are that expense. As dentists, our job is to make money too, by serving you, bringing good health and care to you and your mouth. If WE do it right, we both win. You will be healthier and we will be wealthier, and the exchange was mutually beneficial for both! Yay us!!! If insurance does it right, they get wealthier and the dentist gets the blame for being “so expensive”. When everyone cooperates, the dentist finds the best plan FOR the patient, and the dental plan lowers fees and provides some payment- then the doctor is compensated well, and the patient is healthier and happier. Our patients appreciate the extra time we take the time to make sure everyone works on their behalf.