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We cooperate with all insurance companies, and will file the necessary paperwork to make certain that you get the full amount that your policy provides for a given procedure. You are of course responsible for paying the difference between what your policy pays and our fees.

 

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Some Straight Talk About Dental Insurance Plans...

Whether you buy or are provided dental insurance by an employer, there are several things you should understand. Like other types of insurance, the price of the policy (monthly premium) determines what kind of, and how much coverage you get. Most carriers sell policies allowing the purchaser (yourself or your employer) to choose what procedures will, and will not be covered, within a specific time period. When a procedure is excluded, this doesn't mean that it is not "dentally necessary" but rather is a restriction of your plan. Thus, your policy may provide average, less than average, or better than average coverage on an item-by-item basis. It is not unusual to have above average coverage on some procedures and below average coverage on other procedures, all within the same policy. Remember, the extent of coverage is determined by the policy cost.

The second area that affects premium cost is the "ceiling amount" the carrier will pay per procedure, per year. The term that the insurance companies use for this is"UCR" or Usual, Customary, and Reasonable. What does Usual, Customary, and Reasonable mean? The insurance company determines the fee of a particular procedure that varies between 50% - 70% of what local dentists charge.

Let's look at an example. Most local dentists charge $650 for a certain procedure. How much will the insurance carrier reimburse? It depends on the plan. A top-of-the-line plan will pay the full amount, $650. A modest plan will reimburse $400. If the dentist's fee is $650 (the amount most dentists charge), the carrier is likely to state on the Explanation of Benefits (mailed to the patient) that the dentist's fee was above the "Usual, Customary, and Reasonable" fee. This comment would naturally make the patient think their dentist's fee is higher than most other local offices — and it isn't true! What is true is that this particular policy will only pay $400. Keep in mind that the same carrier, selling a more expensive plan, might pay $650, the full amount, for the same procedure.

Our core value is "Dentistry for the Discerning Patient." Our practice is based on providing the latest in diagnostic and treatment techniques coupled with the advantage of classic, conservative, time-honored methods. Our patients demand a high level of care, and we comply with their wishes by:

This high level of service is expensive to provide and many insurance companies will not pay or will only partially pay for the level of care we provide. It is for these reasons we choose not to participate in insurance or managed care programs — instead opting to cooperate with insurance plans.

So it comes down to choices. What level of expertise and care do you want? How important is how you look and feel? What is your level of comfort in having an insurance provider dictate the value of a complex dental procedure that directly impacts both look and feel?

We sincerely hope that you will choose us as your primary dental care provider, entrusting us with the important job of maintaining your dental health and making you look and feel good. If you have dental insurance our staff will be happy to submit claims on your behalf and provide the necessary documentation and support to assure that you obtain the maximum benefits from your policy. We will also be happy to submit any pre-determination of insurance benefits for you, at no charge. We will do everything that we can to make you feel comfortable in discussing any financial concerns you may have and are prepared to work with you in obtaining "excellence in dentistry" at an affordable level. Please contact us with any additional questions or concerns you may have.