Insurance Information

Did you know?

Many dental insurance plans are just sitting there with benefits unused and poised to go to waste as soon as the clock strikes midnight on December 31. In fact, dental insurance companies count on making millions of dollars off of patients who never use their insurance benefits, because unbeknownst to the consumers, many of these plans provide coverage up to a certain dollar amount annually. We can help you understand your benefits and what expires at the end of the year.

Insurance companies certainly aren’t going to alert you of unused benefits, and most patients are too busy to study how much remains on their policies. If you are unsure of what unused insurance benefits you have remaining in 2016 and are in need of treatment or preventive care, don’t hesitate to call us and we can help you understand your benefits. We are here to help you secure the insurance coverage available to you on every dental procedure you schedule. This time of year is an excellent time to take care of any hygiene visits or dental treatments that you might have been putting off.

Insurance

We accept many dental insurance plans and will file claims on your behalf, saving you the time and hassle. Our knowledgeable benefit coordinators can help you maximize your dental benefits and minimize your out-of-pocket cost. We will tell you upfront what your insurance plan will pay for and offer options for taking care of any remaining balance.

Insurance Carriers

We accept and honor most dental insurance plans. The following are just a few of the dental insurance carriers we’re providers for:

Please call our office for more details at: (619)-285-0950

Insurance FAQ

What’s a covered benefit?

Treatment that is recommended by a dentist, is listed on the fee schedule, and accepted under the terms of your group’s plan.

What’s an optional treatment?

Treatment that is either not listed on your fee schedule or more than the minimum to restore the tooth back to its original function.

What’s the difference between indemnity, PPO, HMO, & discount insurance plans?

Indemnity or Traditional Insurance reimburses members or dentists at the dentist’s UCR (Usual, Customary & Reasonable fee). This allows the subscriber to go to any dental office without being limited to a panel.

PPO

(Preferred Provider Organization) is the most common form of insurance. They provide members with a list of participating dentists to choose from. The dentists on this list have agreed to a lower fee schedule, which provides you with greater cost savings. They also assist with insurance billing. Most companies pay 50% on major treatment (crowns, bridges, partials), 80% for basic care (fillings), and up to 100% for preventative care (exams, x-rays, basic cleanings). Annual maximums generally range from $1,000 to $2,000.

HMO

Also known as capitated or prepaid insurance, was designed to provide members with basic care at the lowest rate. Participating providers receive a monthly capitation check for patients assigned to the office. This amount is only a few dollars and is intended to offset the administrative costs. HMOs generally don’t pay for services rendered. Fees are usually greatly reduced, but the patient is solely responsible for paying the doctor.