Insurance Information

We are not contracted with any HMO plans so if you MUST go to a dentist on your plan you will not get any reimbursement for coming here. Although we are NOT contracted with mostly all PPO plans you can still use them here but there may be a different reimbursement schedule which may lead to a slightly larger co-payment. We are confident that this difference in cost will be more than offset by the high quality, integrity and service you will receive here. We would be happy to assist you in evaluating how your particular insurance may be utilized by coming here.

As part of our commitment to providing outstanding service to our patients we will complete and submit your dental forms for you so that you may receive maximum reimbursement to which you are entitled. We will estimate your portion of the fees and ask that you pay that at time of service unless other arrangements are agreed upon and made. After all insurance payments are received any differences can be settled at that time.

A Few Words About Dental Insurance:

Dental insurance is essentially a contract negotiated between your employer and an insurance company. The benefits that you receive are based on the terms of that contract. The services that you are eligible for and their respective covered percentages as well as any deductibles or exclusions are decided upon by your employer based on the cost of the policy. Dental plans usually have a goal of providing only basic care for specific dental services. You cannot really expect dental plans to completely cover your dental needs but act more as a financial assistance to those needs. This is why there is so much confusion concerning dental insurance.

We develop your treatment plan based on YOUR best interest and not that of the insurance company. Our goal is to help you achieve optimum dental health which is never the goal of an insurance company. We refuse to compromise your care based on their restraints and limitations and this is the main reason for not maintaining contracts with these companies. Their goal, by providing only the negotiated benefits for the specifically selected services, is to maximize their profits. This is where most of the confusion about dental benefits stems from. The fact is that dental insurance rarely covers 100% of any dental fee and in many cases covers less than 50% or nothing at all. In addition, almost all plans have a dollar amount limitation (which has changed little if any in 30 years) which once it is reached they will no longer pay anything regardless of how essential that service is to your dental health.

Pre-determination is a ploy by the insurance companies to control the amount of dentistry you receive. It is NOT legal to deny you reimbursement because treatment was not pre-determined. However an insurance company can try to deny a claim based upon THEIR perceived need of a covered procedure. This is why it is important for YOU to understand the need for any treatment performed by us so that the insurance company doesn’t cloud the reason why it is being recommended or performed.