General | You and your dental plan | Dental plan co-paymenents | My dental claim reimbursement was limited or declined

Dental insurance is a highly complex benefit that creates confusion for many dental patients. The complexities of dental insurance and the lack of sufficient information provided by some insurance companies make it very difficult for some patients to properly understand their benefits.  Even more confusing is understanding how to properly work with your dental insurance company to achieve the highest level of benefits to which you are entitled.

What is Dental Insurance?
Dental insurance is a contract between you, your employer and your dental insurance company.  The benefits that you receive are based on the terms of the contract that were negotiated between your employer and the dental insurance company and NOT your dental office.  The goal of most dental insurance policies is to provide basic care for specific dental services. The services selected are based on the cost of the policy to your employer and the negotiated arrangements with the dental insurance company.

Because the benefits you currently have are decided between your employer and the insurance company, many services are not covered.  The selection of non-covered services is not based on what you need or want, but is based strictly on the contract with the insurance company.  Dental insurance companies rarely cover 100 percent of any dental fee and, in many cases, cover 50 percent or nothing at all. Also, most dental insurance plans have a dollar amount limitation each year. Once this limit is reached, no other services will be covered by your dental insurance company regardless how essential the service may be to your dental health.

Covered and Non-covered Services
Unfortunately, some of the services that you may need or want will not be covered by your dental insurer.  Our goal is to help you achieve and maintain optimal dental care. 
We do not want to compromise your care based on restraints placed by an insurance company.

Nonassignment of Benefits
Since dental insurance is a contract between you, your employer and your dental insurance company, payment of benefits are assigned to you, NOT your dental office.. Therefore, we kindly ask for payment from you at the time of your scheduled appointment and your insurance company will reimburse you.

How Our Office Helps
Our office will do everything possible to help you understand and make the most of your dental insurance benefits.  Our office will electronically submit dental insurance forms to your insurance company to achieve the maximum reimbursement to which you are entitled as quickly as possible.

Predetermination Policies
Many insurance companies require authorization for major procedures in advance.  Our office will do everything possible to help you maximize the insurance benefits to which you are entitled. Patients need to understand that you are responsible for all fees not covered by your insurance company.  Naturally, we always provide you with the full fees in advance of major treatment so that you know the exact cost.  

Ask Us for Help Any Time
Anytime you have a question about your dental insurance, please feel free to ask us. 

Our Philosophy
Our office remains dedicated to providing optimal care for every patient and working with you to achieve that goal.  We pride ourselves on helping you in any way and in continuing to provide the quality of care to which you have become accustomed.

Please let us know if you have any questions – it would be our pleasure to help you. top