IMPORTANT INSURANCE INFORMATION

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We are CONTRACTED / PREFERRED PROVIDERS

for the following PPOs - clickable Insurance Links:


Aetna

ameritas

Assurant

Blue Cross Blue Shield Arizona

CIGNA 

Connection Dental

Delta

Delta Tricare - retired military

GEHA

Humana

Meritain

MetLife

Principal

SunLife

**United Concordia  - Unfortunately, we are no longer ABLE to contract with United Concordia~This insurance company has begun to deny necessary procedures like fillings, x-rays and crowns. This Poor habit places the Burden of payment 100% onto patients.

United HEaLthcare

 

We will file

(AND in most cases write-off our fee to the fee that is allowed by insurance)

MOST OTHER insurances for you

We do not accept HMO/DMO or Capitation Plans

 

Keep Scrolling Down for More Important Information

GREAT INFO @ THE BOTTOM OF THE PAGE!! 


KNOW the difference between asking:

"Do you accept my dental insurance"

OR asking:

"Are you a contract and/or preferred provider for my insurance?"

Unfortunately, many offices choose to answer the question of, "do you TAKE my insurance" as "Yes" and they may not be providers for you

 There is a BIG difference in asking if an office "takes" insurance and asking this question instead, "Are you a PREFERRED PROVIDER, or ARE YOU CONTRACTED with my insurance?"

This difference is very important!  When a dental office is a CONTRACT/PREFERRED PROVIDER it means that the office has agreed (contracted) to accept a limit on fees set by the insurance company.  If an office is not Contract/Preferred, that office has the right to charge YOU the difference between the limited fee that insurance will pay and the full, actual fee amount charged by the office.

As you can see, visiting a Contracted/Preferred Provider can save the patient hundreds of dollars out-of-pocket (25-30% on out-of-network fees).

IMPORTANT SUBSCRIBER (PATIENT) INFORMATION


 More important information regarding insurance.

Important Patient Information:

     What is the NAME of your insurance company?

     What is your GROUP NUMBER?

     What is your INDIVIDUAL ID NUMBER?

     What is the ADDRESS and PHONE NUMBER?

     ►TAKE YOUR CARD TO YOUR VISIT!!!

     ►Do you know what your deductible is? 

     ►Do you know what your annual limit is?

     ►Do you know if you have a co-pay?

         Most dental and medical provider offices will file insurances for their patients. HOWEVER, dental and medical offices do not work for (in conjunction with) the insurance company. This means that when an insurance company designates a "Patient Portion" on services, the patient is responsible to pay the provider that designated amount.  Many offices wait to be paid by insurance, and the common practice of most provider offices is to estimate "Patient Portion" at the time of each visit.

More and more frequently, dental and medical offices are requiring patients to pay the entire bill at the time of services.  The patient is then reimbursed by their insurance company for payment of services.

WE DO NOT REQUIRE full payment, but WE DO COLLECT patient estimated payment at the time of services. This payment, collected as "Patient Portion", is only an estimate as the insurance company has the final "Patient Portion" assignment.

Even MORE Important Insurance Info  


Even MORE!! Great Questions for you to ask the insurance sales person and/or your Company Human Relations Person

     If you have a CAPITATION plan, it is important to know that it will pay VERY little to providers. Private and small practices cannot contract with this type of plan. Normally, the only dentists who contract with these plans are clinics/cattle-car operations.

     When you purchase Fee Agreement cards, you are not purchasing dental insurance. You are only buying individual office write-offs. We offer patient discounts to those who do not have insurance, so purchasing this type of card is essentially a waste of money

     There are HUGE differences in Premier, PPO, HMO, DMO and capitation plans. Make sure you are clear about what you are purchasing.

     ►There is more and more variety of CLAUSES that are sold WITHIN the same plans (Same plan number). It is wise to understand the specific clauses that you have purchased.

     ►Many insurances have "missing tooth clauses" meaning that the insurance will NEVER cover any expense related to teeth that are already missing.

     ►Many insurances have "12 month waiting periods" meaning that subscribers have to wait 12 months before insurance will begin to pay for services.

      Even if you have 2 insurances, some dental insurance companies will NOT cover if other insurances have paid first (as primary)

     ►Understand dental co-pays - They are much different that medical co-pays.

     ►If you are not happy with the way your dental insurance pays for services you can, by ALL MEANS, complain to your HR department and to the insurance company!!!! Providers are not the entities who make the payment decisions of your insurance company - the insurance company sets the policies and your company agrees to obligate its employees to those decisions.

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