My office is a fee-for-service dental office. In order to provide the highest quality care I prefer to remain totally independent, and do not belong to any dental plans. This approach allows me to select the best care based on your unique medical and dental needs. My name will not appear on any insurance lists. Your treatment should be based on our professional relationship and not a contractual relationship between you, your employer, and an insurance company. Prior to starting treatment I suggest that you acquaint yourself with your coverage including the dollar amount of your annual maximum or remaining calendar year benefit as well as your deductible.

My office does not accept insurance assignment. We, as a courtesy, will submit your dental claim to your primary and secondary insurance carrier(s) with the necessary documentation required so your benefits can be sent to you as quickly as possible. Each and every insurance claim, no matter how simple, requires about one half hour to process. Our insurance coordinators will record and itemize each service and financial transaction, print your claim form, duplicate any x-rays, copy your periodontal charting, and send each claim to the address you provided. Each claim is reviewed, prior to its submision. We follow this procedure so that you can receive your benefit as quickly as possible.

Important facts you need to know about dental insurance

Your explanation of dental benefits (EOB) may state that dental fees appear higher than their usual and customary table of fees. It is important that you understand that insurance companies take a survey of a specific geographic area and determines an average fee for each procedure. Once the insurance company sets the average fee, they then take 90 % of that number and calls that the usual and customary fee. This exercise is completed about every 5 years. This formula fails to keep up with the costs of providing today’s quality care.

Dental insurance is not designed to provide 100% benefit. It is only meant to be an aid. We feel it should be called dental assistance rather than dental insurance.

We have found that some insurance plans tell you that you will be covered “up to 80%” or 100%,” however they do not clearly explain the plan’s fee schedule, annual maximums or limitations. Our experience is that most plans cover about 35% to 50% of major services up to the plan’s pre-established maximum fee allowance, and after applying any deductibles.

Some insurance companies may say dental fees are above the usual and customary allowance rather than explaining that the benefits they provide are below what is considered normal. Your benefit is based on the premium paid into your plan less approximately 25% administrative costs. Keep in mind that the insurance company needs to make money. Their objective is to limit payments and to have you wait for reimbursement. They can then make use of “your” money. The level of care you receive is certainly not their priority.

Do not hesitate to ask us questions about your dental insurance. We will do all we can to assist you in maximizing your dental benefits. However, please remember that your insurance benefit is determined by a contract between you, your employer, and the insurance company. We have no input or involvement in that process.