Information for Patients with Dental Benefits
Your dental benefits are a contract between you, the insurance company and your employer, not the dentist. We are not affiliated with any insurance company.
Our concern is for your dental health. We always recommend treatment that best suits your individual needs regardless of your insurance coverage.
Most Dental benefits plans do not cover 100% of your needed dentistry. Some companies offer 100% percent coverage of a prior years fee guide. We are charging current fees, which are based on our clinical expertise, quality of care and materials.
Insurance companies are changing policies frequently. They do not inform dental offices of these changes. Please inform us of any changes to your coverage otherwise we have no other way of knowing.
For a more explanation about dental benefits click here to read the ODA article "Dental Benefits Explained"
Our concern is for your dental health. We always recommend treatment that best suits your individual needs regardless of your insurance coverage.
Most Dental benefits plans do not cover 100% of your needed dentistry. Some companies offer 100% percent coverage of a prior years fee guide. We are charging current fees, which are based on our clinical expertise, quality of care and materials.
Insurance companies are changing policies frequently. They do not inform dental offices of these changes. Please inform us of any changes to your coverage otherwise we have no other way of knowing.
For a more explanation about dental benefits click here to read the ODA article "Dental Benefits Explained"
Plan Information We Need to better help you:
- Yearly Maximum $____________
- Yearly deductible $____________
- Fee guide used? ____________________
- What is the calendar year?
- Or is it Rolling ? _________________
- Is there crown and bridge coverage? Yes/No
- Is there denture coverage? Yes/No
- If applicable - how often can dentures be replaced?____________________________
- Is there ortho coverage? Yes/No, Lifetime Max? $____________9. What percentage does your plan cover? _________
- Basic work: ________%, Major Work: _________%
- Are recall every 6 or 9 months? ________________
- How many units of scaling are covered per year? ________units
Insurance Terms you need to Know
Annual Maximum - Most insurance companies have an annual maximum amount of coverage for each patient listed under the insurance policy. This coverage may be changed and patients may not be informed.
Deductible - The dollar amount the patient pays toward their treatment total before insurance coverage begins.
Eligibility - determines who is covered under the insurance policy.
Exclusions - Many dental services and treatments that are clinically necessary are not covered by dental insurance. These exclusions are usually described in the patient's insurance booklet, but be aware that more treatments are being excluded to reduce costs.
Co-payment or "Out of Pocket Portions" - are part of the treatment fee not covered by dental insurance. The insurance company will pay a certain percentage of the treatment, but they rarely cover 100%.
Dual Coverage - is when both spouses are covered by different insurance plans. The insurance companies usually co-ordinate the benefits so that the patient does not receive more than 100% of the cost of treatment.
Assignment - of insurance is when a patient signs a section of the insurance form, which allows the dentist to receive payment directly from the insurance company. Insurance companies now often send payment to the patient. This should be forwarded to the dentist as soon as possible.
Deductible - The dollar amount the patient pays toward their treatment total before insurance coverage begins.
Eligibility - determines who is covered under the insurance policy.
Exclusions - Many dental services and treatments that are clinically necessary are not covered by dental insurance. These exclusions are usually described in the patient's insurance booklet, but be aware that more treatments are being excluded to reduce costs.
Co-payment or "Out of Pocket Portions" - are part of the treatment fee not covered by dental insurance. The insurance company will pay a certain percentage of the treatment, but they rarely cover 100%.
Dual Coverage - is when both spouses are covered by different insurance plans. The insurance companies usually co-ordinate the benefits so that the patient does not receive more than 100% of the cost of treatment.
Assignment - of insurance is when a patient signs a section of the insurance form, which allows the dentist to receive payment directly from the insurance company. Insurance companies now often send payment to the patient. This should be forwarded to the dentist as soon as possible.
