Dental Insurances: A Note to parents





Dear Parent,

Understanding health & dental insurance benefits is frequently frustrating and often confusing for everyone involved. There are hundreds of insurance carriers, policies and plans with many sub-plans with varying percentages for differing services. Some Insurances make it more difficult than others to locate and clearly define plan benefits, percentages, frequency limitations, maximum yearly benefits, and co-payments for both subscriber and dental offices.

Leveraging our years of experience, we do everything in our power to accurately estimate patient and family dental benefits, plan coverages and out-of-pocket expenses for every visit. We work extremely hard and put in a lot of time to make sure we are as accurate with billing and insurance as possible. However, please understand, it is impossible for us to be experts in all insurance plans and benefits packages and we can never fully predict nor guarantee what an insurance plan will ultimately pay out in the end.

The dental benefits plan you have is a contract between you, your employer and the insurance company. We estimate, collect and bill your insurance as a courtesy for you to help make every visit as easy and stress free as possible. Ultimately, however, it is not the dentists but rather the subscriber’s responsibility to know their plan, benefits, percentages, out of pocket co-pays, etc.

Please contact your insurance carrier directly for further assistance if you would like clarification on your plan benefits.

Sincerely,

Dr. Johnson

We accept all PPO insurance plans

Below are some examples of the plans we accept
Aetna Ameritas Anthem Blue Cross Assurant Anthem Blue Shield Cigna Delta Dental Dentemax Dental Health Alliance Geha Connection Dental Guardian Health Net Humana Lincoln Financial Group Met Life Premier Access Principal United Health Care United Concordia



Important Information for Patients with Delta Dental Insurance



We accept Delta Dental PPO Insurance as an "out of network" provider. We will help you maximize your benefit BUT there are some important things that you should know as it relates to our office. To attempt to force providers like me to contract "in-network" and agree to more than 50% reduction in reimbursement fees, Delta Dental has chosen to be the only insurance that sends insurance benefit checks directly to YOU (the subscriber) instead of our office.


Here is how the process works with every other insurance compared to Delta:


ALL INSURANCE PROVIDERS (Except Delta)


✔ A treatment plan is generated showing our full fee, the estimated portion to be covered by your insurance benefit, and the remainder is a co-pay due at the time of service

✔ As a courtesy on your behalf, our office mails the insurance claim to the insurance company

✔ The insurance company sends us the benefit check within 2-3 weeks of receiving the claim

✔ Any over/underpayment is addressed by issuing a refund or mailing a statement showing any amount


EXAMPLE All Insurances Except Delta Dental

$400  Full Fee

$340  Estimated Insurance

$60  Copay

$60  Amount due at time of service

$340  Insurance mails payment to office




DELTA DENTAL


✔ A treatment plan is generated showing our full fee, the estimated portion to be covered by your Delta Dental benefit, but Delta forces us to collect the full fee from you at the time of service because they send you the check instead of us

✔ As a courtesy on your behalf, our office mails the insurance claim to the insurance company

❌ Delta Dental sends the insurance benefit check directly to YOU written in YOUR name


EXAMPLE Delta Dental Only

$400  Full Fee

$340  Estimated Insurance

$400  Copay due at time of service

$340  Insurance mails payment to you