Do you ever wonder why you always receive a bill from the dentist even though you have dental insurance and paid your co pay?
Well I used to too, until I became a dentist myself and was enlightened to the whole world of dental insurance. That’s why this article will help those not as fortunate as me to understand this mystery a little better.
First of all let me clarify that dental insurance is completely different from medical insurance.
Some medical insurance may cover dental treatment like wisdom teeth extractions ,etc., but in general you cannot go to a dental office with medical insurance and expect to be covered for dental work.
Dental treatment has its own separate insurance plans. Unfortunately, the lack of sufficient information provided by some dentists and some insurance companies makes it almost impossible for patients to properly understand their benefits.
Dental insurance is typically a contract between your employer (this could be you if you’re self employed) and a dental insurance company.
The benefits that you receive are based on the terms of the contract that were negotiated between your employer and the dental insurance company and not your dental office. The goal of most dental insurance policies is to provide only basic care for specific dental services.
Well, what if you need some particular type of dental treatment and your insurance company does not cover it? Dental insurance companies don’t look at what a person needs but go by what has been negotiated between them and your employer.
For example, if a patient has a small cavity, I would do a tooth colored filling rather than a silver filling, because less tooth structure needs to be drilled, it’s a bonded filling giving a better seal, looks better, usually does not need any anesthetic injections making it painless, and I believe it’s a better restoration in the long run.
For a silver filling the tooth has to be drilled more as it needs a certain depth even if your cavity is not that deep, running the risk of making your tooth sensitive.
Also silver fillings look ugly when you open your mouth. So tooth colored (composite fillings) are the better treatment for the patient.
Most insurance companies cover 80 percent of fillings, but they mean silver fillings, and you have to pay your 20 percent plus the difference between the cost of the silver and composite filling.
That’s where the confusion typically arises when you get your dental bill.
Another confusion is between a deductible and a co pay. A deductible is a one-time fee that you pay each year to your insurance company. It’s collected at your dentist’s office but it goes to the insurance company. You can think of it as an annual fee charged by the insurance company for processing your claims, etc.
A co pay is a payment you make to the dentist as a part of the payment for a particular treatment. A co pay will vary depending on what you had done.
Say if your insurance pays 60 percent for root canals, your co pay will be 40 percent of the amount you need to pay for the root canal. A dentist participating in an insurance plan is bound by his contract with the insurance company to collect any co pays that they state he or she should collect.
At Rane’s Exclusively Yours Dental, our parent office, and Rane’s Dental Aesthetics, our dental specialty extension, our managers, Mary Prima, Kelly Szwed, and Jennifer Lee make sure that these things are discussed with you before we do any treatment so that nobody gets shocked with that dental bill.
All treatments are presented to our patients by the dentist first and then again by our managers to explain how the billing will work for these procedures.
Rane’s Exclusively Yours Dental participates in many dental insurance plans like Aetna, Delta, Guardian, Cigna, Horizon Blue Cross Blue Shield, MetLife, United Healthcare, and some others.
We even offer interest free financing if you need it. So before you receive another dental bill and have fumes coming out of your head come to us where we can turn your dental bill into bite size pieces!!!
Rane’s Exclusively Yours Dental, a dental boutique, is our parent office providing mainstream general and cosmetic dentistry for children and adults.
Using the same style of practice, we have a specialty location right across the street; Rane’s Dental Aesthetics, in the new Plainsboro Village Center, providing orthodontics, Invisalign (the invisible braces), periodontics, implants, and advanced cosmetic and sedation dentistry.
With general dentists and specialists on board at two locations right across from each other, we have eliminated the need to travel all over town for dental treatment while providing for the constantly growing demand for our services.
This way we have created a center to provide all phases of dentistry on site for children and adults right in downtown Plainsboro and can provide 200 percent satisfaction.
Rane’s Exclusively Yours Dental. Plainsboro Shopping Center (Beside Super Fresh and NYSC), 10 Schalks Crossing Road, Plainsboro, 609-275 1777. www.ranesdental.com
Rane’s Dental Aesthetics. (A Dental Specialty Extension), New Plainsboro Village (Beside 1st Constitution Bank), 11 Schalks Crossing Road, Plainsboro. 609-750 1666.