Insurance FAQ's

About Your Insurance:

This office prefers to have the doctor/patient relationship separate from insurance.  We have found that too often there is confusion which delays the process and ultimately damages the doctor/patient relationship.  It is this relationship that is incredibly important to us and must be protected for the good of all.

Patients With Insurance: As a courtesy to our patients, we are happy to help you prepare and mail your insurance claim forms from our office.  It is our hope that with our combined efforts we can maximize your insurance benefits.

What's Up With Usual and Customary?

An insurance company typically surveys a geographic area, determines the average fees, and concludes that 90% of that fee is customary.  Included in their fee survey are discount clinics that accept numerous DMO plans and drastically brings down the average. Insurance companies often tell their insured the "fees are above the usual and customary fees" rather than saying, "our benefits are low."  Remember, insurance benefits are a negotiated contract from your employer and because of that insurance varies greatly.

What's a Covered Procedure?

Many insurance plans tell their insured they will be covered "up to 50, 80 or 100%".  The real question is 50, 80, and 100% of what?  You would think the fees charged, but not usually.  Many have specific plan fee schedules which may very well be significantly lower than most dentists in the area.  Other limitations are annual maximums and specific plan exclusions.  Insurance is unfortunately not a Pay-All.  Additionally, some insurance plans do not cover many routine dental services.

How Can We Help You?

Dental insurance benefit reimbursement can be tricky.  Our office staff is knowledgeable and has worked with many dental plans. We will help you by providing the paperwork you will need to file your claim.  Each insurance company has a different relationship with each employer, and thereby each patient.