Do you take my dental insurance?
Maybe. If we’re listed on their website as a preferred provider, probably. To be sure, our office will need to know the name of the insurance company, the name and birthdate of the subscriber, the subscriber ID (or social security number), patient birthday, and a telephone number for the insurance company.
Do I have to pay when treatment is scheduled?
We collect the patient’s estimated portion the day services are provided. If we over-collect, there will be a credit on the account. If we under-collect, we will send you a statement for the unpaid amount at the next billing cycle.
How can I know exactly what my insurance will pay before treatment?
We can usually pre-authorize services, meaning we bill the insurance company before we do anything, they send us both an Explanation of Benefits detailing exactly what they will pay. In our office, we don’t do this routinely, I will recommend it if the procedure is something that I know there are limitations on. I am, however, always happy to pre-authorize at patient request.
Why didn’t my insurance pay for ______________?
Please call the office if this happens. We do our best to know what frequencies and limitations exist on your plan, but we can be surprised. Common reasons something isn’t paid for:
- Too short of a frequency between cleanings (plan pays once every 6 months; the appointment was 5 months and 3 weeks after the last one). We do our best to see that this doesn’t happen, but we see 30ish patients per day, sometimes we miss-schedule. I would recommend knowing what your cleaning frequencies are and verifying every appointment is scheduled correctly (especially if an appointment has changed).
- The plan changed, something that used to be paid for is not any longer.
- The plan “maxed out”. This usually happens when a patient has seen another dentist for services, and we don’t have the information that insurance was used outside of our office. We do not track this, so let us know.
- The plan downgrades, meaning they will pay for a less costly service. An example: many insurances will pay for silver fillings on back teeth. If a patient has resin (white) fillings, the patient will pay the difference between what is paid by the insurance, and the final cost.
- The insurance has terminated (ended). Make sure you let us know if there are any changes to your insurance policy.
I’m looking at buying dental insurance, do you have any suggestions?
My only suggestion is PLEASE talk to the office prior to purchasing dental insurance! I would much rather spend time with a patient explaining exactly how the insurance pays in our office, then explain why they owe so much money after they’ve purchased it…. or worse yet, why the insurance won’t pay us if they come here. There are instances where purchasing private insurance is in the patient’s best interest, and cases where our Dental Plan is a better deal. I am happy to provide information to help you make the best decision for you.
Why don’t you take XYZ insurance?
We have made an effort to balance quality of care with accepting reduced fees from insurance companies. If we are not an in-network provider with an insurance company, it is usually because their fee schedule is too low to cover our costs to provide treatment. We are proud to use local labs and the best quality products, and our fees reflect that commitment.
Any additional questions? E-mail me at firstname.lastname@example.org, and I will respond at my earliest convenience.
- Teri, Office Manager