At Denver Metro OMS we make every effort to provide you with the finest surgical care and the most convenient financial options. To accomplish this goal, we work hand in hand with you to maximize your insurance reimbursement for covered procedures. If you have any problems or questions, please ask our staff. Feel free to call our office if you have any questions or concerns regarding your initial visit. Please bring your insurance information with you to the consultation so that we can expedite reimbursement.
Facts You Should Know About Dental Insurance
Dental insurance can play a significant role in helping patients offset expenses for dental treatment. Since we believe that our patients deserve the very best dental care possible, we would like to share some facts about dental insurance with you.
You may receive a letter from your insurance company stating that dental fees are higher than “usual, customary and reasonable.” UCR reimbursement levels are determined by different methods by the dental plan administrators. They may vary a great deal among dental plans in your local area. The fee the insurance company determines to be “customary” may be very low compared to the area’s average professional fee for the same service.
The amount your plan pays is determined by how much your employer paid for the plan; the less paid for the insurance coverage, the less you’ll receive in benefits.
The dental benefit plan is based upon a contract made between your employer and the insurance company. Should questions arise regarding your dental benefits, it is best for you to contact your employer or insurance company directly. We will do our best to interpret your benefit plan, but we cannot guarantee actual reimbursement coverage from it.
Many plans tell the insured that they’ll be covered “up to 80% or up to 100%” on some procedures, but they do not clearly specify the plan’s fee schedule allowance, annual maximum, or limitations.
Dental insurance benefits are very different from general health insurance benefits. In the early 1970′s the annual maximum for a dental benefit was $1000 per year. Now, over 35 years later, most dental benefit plans still have a $1000 calendar year maximum. Your premiums have increased but your dental benefit coverage has not. Therefore, dental insurance is not meant to cover every dental need you may have. It is meant to be an aid to make dentistry more affordable.
Many routine dental services are NOT covered by insurance carriers.
Please do not hesitate to ask any questions you may have about dental treatment and how to maximize your dental benefits. We want you to be comfortable in dealing with these matters, and we urge you to consult us if you have any questions regarding our services and/or fees. We will fill out and file insurance forms at no extra charge, and will do our best to be sure the appropriate information gets to your insurance company on file. We also ask that you contact your company regarding the specifics and details of the plan it is contracted with on your behalf.