How often should I visit the dentist?
The answer to this question depends on the state of your dental health. For patients with healthy gums, little to no history of decay, good dental hygiene at home, and no significant medical conditions-- we can usually help you maintain optimal dental health with cleanings and check-ups twice a year. However, everyone is different and some patients may need more frequent cleanings or certain dental procedures. After performing a comprehensive dental exam, we will discuss your treatment needs and options, develop a customized treatment plan, and discuss all of your treatment options and the advantages and disadvantages of each one.
Will my dentist take my insurance?
Most dentists fall in one or more categories, and there may be more options than are described here. Some dentists sign contracts with dental insurance carriers and agree to accept or “take” the payment offered by the insurance company as payment in full, even though it may not be the same amount as the dentist charges for the procedure. These dentists are Participating Providers in your plan.
Other dentists do not sign contracts with dental insurance carriers but may still accept or “take” insurance company payments. These dentists are not contractually obligated to accept your insurance carrier’s payment as full compensation and are not Participating Providers. In this instance, you may be responsible for a payment portion over and above the percentage provided by your insurance company.
Still other dentists are not Participating Providers and do not accept payments directly from your insurance carrier. In this case, your dentist will ask that you be responsible for the entire fee but will assist you in filing your claim to receive insurance benefits directly from your insurance carrier.
Other dentists do not sign contracts with dental insurance carriers but may still accept or “take” insurance company payments. These dentists are not contractually obligated to accept your insurance carrier’s payment as full compensation and are not Participating Providers. In this instance, you may be responsible for a payment portion over and above the percentage provided by your insurance company.
Still other dentists are not Participating Providers and do not accept payments directly from your insurance carrier. In this case, your dentist will ask that you be responsible for the entire fee but will assist you in filing your claim to receive insurance benefits directly from your insurance carrier.
What if I need to reschedule my appointment?
Because our patients are so important to us, and we carefully set aside the time everyone needs to receive the best treatment possible. We understand that there may be times when you must change your appointment. If you need to reschedule, please call our office at least 24 hours before your scheduled appointment. We do ask that you try to avoid last-minute cancellations whenever possible.
What is a “UCR” and how is it determined?
“UCR” is the term used by insurance companies to represent the amount of money they are willing to pay for a specific dental procedure. There is no standard fee used or method for determining the UCR. It also has no relationship to the fee charged by your dentist. The administrator of each dental benefit plan will determine the fees that your plan will pay for each service which is often based on many factors including: region of the country, number of procedures performed and cost of living.
Why was my benefit different from what I expected?
Your dental benefit may vary for a number of reasons, such as:
- You have already used some or all of the benefits available from your dental insurance.
- Your insurance plan paid only a percentage of the fee charged by your dentist.
- The treatment you needed was not a covered benefit.
- You have not yet met your deductible.
- You have not reached the end of your plan’s waiting period and are currently ineligible for coverage.
How long does it take for a claim to be paid?
The time for a dental insurance carrier to process an insurance claim varies. At least 38 states have enacted laws requiring dental insurance carriers to pay claims within a timely period (ranging generally from 15 to 60 days). If you want to file a complaint about a delayed payment, contact the insurance commissioner in your state. They want to know if your insurance company does not pay within the period allowed by your state law.
