A few words about insurance
Although difficult to remember, there was a time when dental insurance did not exist. Prior to the 1960’s dentists provided care to patients, and patients paid dentists for those services. There were no PPO’s, HMO’s, EOB’s, and certainly no HIPAA. Obviously, the world of healthcare has changed dramatically since those days. In the interest of providing some clarity about these issues, we are providing a few facts that will help you understand the world of insurance in which we live.
Medical and dental insurance policies are contracts to which subscribers, insurance companies, unions, employers, and patients are all parties. Those parties negotiate the terms and conditions of those contracts.
As dentists, we have no role in determining what services insurance companies cover or exclude, and we have no control over the processing of claims or the benefits which are paid. However, we do help our patients maximize their insurance benefits so that they are able to obtain the dental care they need.
As a courtesy to our patients, we contact their dental and medical* insurance companies to obtain information about their eligibility, benefits, exclusions, and other coverage details. This information is important in helping us develop an appropriate treatment plan.
We make dental treatment more affordable for our patients by allowing them to assign their dental and medical benefits to our office and thereby reduce their out of pocket expense.
Finally, we act as advocates for our patients to ensure that their rights are not violated and that they receive the insurance benefits to which they are legally entitled.
“Great, but do you accept my insurance?”
This is the most frequently asked question we get, and the answer is simple. We accept all patients who wish to have us provide their care. If they are covered by an insurance contract which does not restrict who they can see, then that company will pay benefits to us on their behalf. Unfortunately, if they are covered by a company which restricts their choice of dentist that company will not pay benefits to us.
*A final note about medical insurance: Although not widely known by dentists or patients, many services which we typically provide to our patients are eligible for benefits under their medical insurance plans. In many cases, we are able to access patients’ medical insurance benefits to pay for the treatment we provide and thereby reduce their out of pocket expense. Attending many hours of continuing education in the area of medical insurance billing has enabled us to provide this valuable service to many of our patients.