FAQs

First we have to understand what having dental “insurance” really means.

Insurance, by definition, is a way for you to mitigate a catastrophic loss that occurs in an event like a house fire, car accident, or skiing accident that requires you to have surgery in a hospital. Dental “insurance” is not quite like that. It is more like a coupon book with limitations, restrictions, and waiting periods.

Dental insurance can at times help offset the cost of treatment but doesn’t pay for it entirely.

We do our very best to estimate your portion of the payment before you leave but with literally hundreds of insurance companies and thousands of individual plans that change ever year, it’s simply impossible for us to know all of them. That’s why it’s important for you to know your plan and take charge of your health!

We do our best to estimate your out-of-pocket cost before you leave our office. It’s always our goal to be as accurate as possible about what you owe for your visit. As much as we try to be experts on every person’s dental insurance, our real expertise is dentistry! Please remember that each insurance company has dozens of plans that an employer can purchase for an employee. We encourage all patients to be advocates of their own health. But rest assured that we will do everything in our power to make sure you get the full benefit owed to you by your insurance company.

Here are a few reasons why you may have received a bill:

• Your insurance plan paid a lower percentage than expected for the procedure.
• The treatment you needed was not covered by your plan.
• The insurance company decided you did not need a procedure that the doctor identified as necessary or downgraded a procedure code.
• You have not met your deductible.
• You have not reached the end of your plan’s waiting period and are ineligible for coverage.
• You’ve maxed out your plan (used up all your benefits on other procedures) and no longer have coverage until the plan resets next year.

Think about it like this. Pretend that your insurance card is like a debit card. If the procedure is covered, there’s money in the bank to pay for it. You wouldn’t spend money without knowing it’s there waiting on you in your checking account. Insurance is similar. If you know your plan, you will know whether the funds are there to pay for services.

But insurance can be really confusing. That’s where we come in. We will take the time to explain your benefits to you as best we can. It’s why we have so much information on our website. We want to educate you so that you can be empowered to take charge of your health and get the full benefit of the insurance you work hard to pay for.