Insurance Q & A

Four Common Questions About Insurance :

• Which dental insurances do you accept?
• • Delta Dental
  • Guardian
  • Metlife
  • Aetna
  • Principal
  • Cigna
  • Humana
  • Ameritas
  • United Concordia
  • Blue Cross/Anthem
  • Blue Shield
  • Premiere Access
  • Reliance Dental
  • Connection Dental
  • Lincoln Financial
  • Dental Health Alliance
  • First Dental Health
  • Dental Benefit Providers
• Why doesn't my insurance cover the cost of my dental treatment?
• Dental insurance isn't really insurance (defined as a payment to cover the cost of a loss) at all. It actually is a benefit, typically provided by an employer, that helps employees pay for routine dental treatment. The employer usually buys the plan based on the amount of the benefit and how much the premium costs per month. Most benefit plans are only designed to cover a portion of the total cost of treatment.
• But my plan says that my exams and certain other procedures are covered 100 percent.
• That 100 percent generally refers to what the insurance carrier allows as payment toward the procedure, not what your dentist or any other dentist in your area may actually charge for that service.
• I received an Explanation of Benefits from my insurance carrier that says my dental bill exceeded the "usual and customary." Does this mean that my dentist is charging more than he/she should?
• Many carriers refer to their allowed payments as UCR, which stands for "usual, customary, and reasonable." However, this does not mean exactly what it seems to mean. UCR is actually a listing of payments for treatment negotiated by your employer and the insurance company. The payment listing is related to the cost of the premiums and the geographical area where you live. In almost all cases, the payments are usually less - and frequently much less - than what any dentist in your area may actually charge for these dental procedures.
• My insurance plan does not go into effect until next month. Why won't my dentist do my treatment today, then send in the claim next month so my insurance will cover my treatment?
• Individual state laws regulate these issues. It is insurance fraud to change the dates of service on a claim! Both the patient and the dentist can be prosecuted for doing this.

More questions? Give us a call at (415) 618 0890 or submit an online query. We’ll be glad to help.