Helping you with Your Financial Needs
We know when you have your dental work done that financial and insurance questions can be a real concern. We have tried to include some answers to questions that are most often asked. If you don’t see the answer you are looking for, give us a call…we’re here to help.
CareCredit℠ offers Special Financing and low monthly payment options, no up-front costs, and no-prepayment penalties so you can show off those pearly whites as soon as you’re ready.
You may not understand the explanation of benefits that your insurance sends you after paying your claim. If so, you are not alone and we are here to help.
There are a number of reasons why your share as the patient will be larger then you anticipate.
Carriers typically pay on a percentage. This percentage is figured on a schedule your insurance carrier has set up. It is sometimes referred to as “UCR”. This means that the plan pays an established percentage of the dentist’s fee or the schedule limit, whichever is less. Although your carrier may term these customary for an area, they may or may not reflect the prevailing fees charged in our area. Insurance carriers are not required to disclose how or how often these schedules are updated.
Carriers may have a “least costly alternative” clause. Instead of paying for the service you actually receive, they may pay on something similar with a lower fee. They expect you to pay the difference between their suggested treatment and the better treatment recommended by our doctor.
You may have already spent all your benefit dollars for the current year. As the plan purchaser, your employer has decided on the “maximum levels of reimbursement. Even though the cost of dental care has significantly increased over the years, the maximum levels of insurance reimbursements have remained the same since the late 1960’s. If you had 1,000 benefit then, you might expect 3,000 to 4,000 now, yet 1000-1500 is a common maximum level.Your plan also has some things that are “excluded” and will not be considered at all. This may include the replacement of teeth extracted or lost before the plan took effect. This does not mean these treatments are not necessary to your dental health. The doctor will help you consider your treatment options and outline the long term benefits of some things that may not be covered.
Above all, remember that your employer bought a policy that does not include some treatments to keep the cost of the plan down. He expects you to pay for some things yourself. Most plans are designed to “share” in your dental care cost. Our office makes every effort to help explain dental plan issues to you. Although we cannot guarantee benefits, our long term experience, contact with insurers and continuing education will give you the edge when deciding on your dental treatment.