Here we have compiled some frequently asked questions regarding dental and medical insurances. We hope these will help you understand the role of dental insurance a little better. Feel free to contact our treatment coordinator at any time for any questions that you may have.
Click on each tabs below to learn moreWhat do I need to know about my dental insurance?
Over the years, patient’s expectations and demand for dental services have increased, however, dental care covered by dental benefit plans is comparatively limited.
Unlike medical insurance, which gives you a million dollar lifetime maximum, most dental plans provide a small yearly allowance. The average allowance is $1,000. That amount helps patients secure some of the needed care but not all. There may be deductible and co-insurance involved. It may also provide for two preventative visits per year.
If you have any concerns regarding your dental Insurance benefit, our treatment coordinator would be happy to sit down with you and answer any questions that you may have.
At Santa Teresa Dental, we prescribe the treatment that is optimum for your oral health. We absolutely do not allow the insurance companies dictate patient’s treatment plan. There may be recommendations that are not covered by your dental benefit plans. However, it does not mean that it is not needed. It simply indicates that those procedures were the specific exclusions of your policy.
We will provide all documentation needed, which often includes radiographs, intraoral images, models, gum charting and letter of medical necessity.
We submit all claims electronically. When a claim is denied, we investigate the reasons and appeal on your behalf.
Costs not paid by dental benefit plans are the patient’s responsibility.
Groups with a non-duplication of benefit rule in their plan only allow the secondary carrier to pay the difference between what the primary carrier actually paid and what the secondary carrier would have paid if it had been the primary carrier.
When there are many treatment options available, most insurance companies opt to make reimbursement for the lowest cost option.
For example, insurance plans often pay for amalgam (silver) fillings and not tooth color fillings for the back molars. The tooth color fillings are considered cosmetic in this case. Patients will pay for the difference in cost.