We are well under way into the 2016 calendar year for insurance benefits, and while you may not have come in to see our Parkcrest Dental providers yet, now is the perfect time to start thinking about how any changes to your dental insurance may affect you and your family!
At Parkcrest we love helping you obtain the absolute best dental care possible, and as a courtesy we are happy to file claims to your insurance company for you! Dr.’s Scott, Harrison, Dills, Fannin, Hall, Keaster, Sponenberg, and Ropka are providers for several common dental plans, and many patients find that even many out of network plans (that allow patients to choose their own dentist) pay high percentages to our office, making it possible for you to choose the Parkcrest Dental Group provider that is best for you and your family.
We love helping patients get the excellent care they deserve, and will assist patients by filing claims and even pre-authorizations for treatment upon request. We want you to get the most out of your dental care experience at our office, and filing insurance for you to enable you to receive insurance assistance is just one of the ways we make having great smiles easy for the whole family!
In an effort to help you understand your insurance policy and maximize your insurance benefits, we would like to share some information about dental insurance with you.
#1 – Dental insurance is a contract between you (the subscriber), your employer and the insurance company. We are not a party to that contract. There are many times that you as a policy holder will have details of your specific plan that your insurance company will not disclose to your dental providers. This means that specific limitations, exclusions, waiting periods, and alternate benefits paid for certain services may only be made clear in plan documents given directly to the insurance holder.
#2 – Dental insurance is NOT meant to cover all fees. It is meant to be an aid to your investment in your dental healthcare. Many routine dental services are not covered by dental insurance. Insurance benefits given by your insurance company to any dental staff is never an absolute guarantee of benefits. While insurance companies will often provide estimates to dental professionals, the insurance companies are not required to abide by the estimates they give, and any non-contracted services that are not covered by the insurance company are balance billed to the patients.
#3 – NOT All INSURANCE PAYS 100% OF ALL PROCEDURES EVEN IF YOU ARE IN NETWORK. Dental insurance is meant to be a supplement in receiving dental care. Many patients think that their insurance pays 90%-100% of all dental fees. This is not true! Most plans only pay between 50%-80% of the average total fee. Some pay more, some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage or the type of contract your employer has set up with the insurance company
#4 – Usual, Customary or Reasonable Fees, UCR, a term used by your insurance carrier, is an amount which the insurance company chooses to pay for each procedure. It is not always based on the average charge of practicing specialist in the area; it is merely the “allowable” amount they will reimburse. At Parkcrest Dental Group, our fees are within range, if not lower than other pediatric and general dental offices in the area.
#5 – Insurance companies will not release the exact amount they will pay for a procedure until the treatment is completed and the claim is submitted. They will only state the estimated percentage of their fee schedule that may cover. If you have any questions regarding your insurance, we ask that you contact your company regarding the specifics and details of your plan.
At Parkcrest we will make every effort to assure you receive maximum benefits from your policy. As a courtesy to all our patient’s, we are happy to file your insurance at no charge! In order to provide this service, we do ask that you please keep us informed of any insurance changes throughout the year. Please let us know of any changes to name, policy information, insurance company address, or change of employment before your appointment. You will need also need to provide your D.O.B, insurance company name, phone number, group number, and insurance company specific identification number. Once you provide these to our staff of friendly business assistants, they will call your insurance company to get estimates of coverage on procedures. This will better enable us to provide you with personalized treatment plan estimates to get you on track towards excellent dental health!
Please do not hesitate to ask questions about our financial policy. We want you to be comfortable with the investment you have made in your oral health! For more information about dental insurance you can visit: http://www.mouthhealthy.org/en/dental-care-concerns/paying-for-dental-care