Here are 5 facts to know about dental insurance...
FACT 1: No insurance plan covers 100% of services. It is only designed to aid in payments. Most have yearly deductibles and maximums.
FACT 2: Manty insurance companies state they pay 80% to 100%. In spite of what is stated, most plans coverage less than the average fee. The amount the plan pays is determined by the coverage purchased by the employer. The less the patient's employer paid for the coverage, the less the patient receives in benefits. This can be very confusing for patients.
FACT 3: Some insurance companies inform their subsrcibers that the doctor's "fees are above usual and customary fees" rather than saying "your benefits are low." Remember, patients get back in benefits what his or her employer paid toward the plan less the insurance company's profits and administrative costs. This is a basic business principal.
FACT 4: Unfortunately, some routine dental services are not covered by some insurance plans. We always try to inform our patients prior to treatment if we are aware of a service, which is not a covered expense. We inform before we perform.
FACT 5: Generally, the PPOs and HMOs offer lists of participating or "preferred" doctors. This does not always mean that it is a requirement for the patients to choose a doctor from that list. Patients may still have the freedom of choice. We strive for this in our practice.
Submitting claims is a service we provide for our patients. We make every effort to maximize our patients' benefits and keep out of pocket costs as low as possible. The goal of providing quality dentistry can be achieved by not allowing insurance companies to dictate treatment because of plan benefits.
We always remain insurance aware, not insurance driven.