Welcome to our dental family! Dr. Pete and his staff are committed to providing you with the highest standard of care possible. Our office puts in a great deal of time and effort to assure our patients receive the maximum allowed benefit under their insurance plan, however we would like you to understand our office policy regarding insurance assignment. Please keep in mind that your dental insurance is a contract between you, your employer and the insurance carrier. As a courtesy we will bill your insurance company. It is your responsibility to know and understand your plan benefits and update us regarding any changes with your dental coverage. Although we estimate your benefits based on the information provided to us by your insurance carrier, your insurance makes the final determination of payment. Any amount not paid by your insurance company is your responsibility. There are certain cases that the insurance company applies an alternate benefit on service codes submitted. It is the patient’s responsibility to pay the difference. We will diagnose what is in the best interest of the patient, not what insurance covers.
We would like for all of our patients to better understand their dental insurance. The first thing to know is that dental insurance is not insurance at all. Insurance originated as, and is by definition, a pooling of funds to pay for a rare, but catastrophic event. Fire insurance is an excellent example. Originally, medical insurance was also designed this way. Payment for routine office visits, basic medications, and low deductibles are a relatively recent modification in medical policies to create additional employee benefits that are not true insurance but "tax-free" benefits.
At our office, we believe that you deserve the best in dental care. That is why we always present you with the best dental solution possible to treat your personal situation. Each year we provide outstanding dental care to thousands of people. Some have dental benefits, but most do not. If you have dental benefits, congratulations! You are very fortunate.
Dr. McKay in a PPO for Ameritas, Principal, Reliance, Security Life Dental, and The Standard, however, we accept all dental insurances and will file claims for you at no additonal cost and will accept benefit. Read more information below.
Please do the following if you have insurance:
1. Provide complete up to date information on dental insurance coverage for the
patient. This includes information on all plans, if enrolled in more than one plan.
2. Present a valid insurance card at each visit.
3. Pay your portion for services not covered at 100% at each visit. (Includes deductibles, coinsurance and co-payments)
4. Pay within 30 days any balance on your account for any amount due this office, such as deductibles, coinsurance, co-payments or outstanding claims left unpaid by your insurance carrier.
Here are some important things you should know:
Your dental benefits are based upon a contract made between you or your employer and insurance company. If you have any questions regarding your dental benefits please contact your employer or the insurance company directly.
Dental benefits differ greatly from medical benefits. In 1959, most dental benefit plans had a yearly maximum cap of $1,000 & you will be surprised to know that the average dental benefit plan today still has a yearly maximum cap of $1,000. There has been no significant increase in the yearly maximum cap in over 40 years! However, there have been significant increases in your premiums. Dental benefit plans will never pay for completion of your dental care. It is only meant to assist you.
Many people receive notification from their insurance company that dental fees are "above usual and customary". An insurance company determines their reimbursement level by surveying a geographical area, calculating the average fee, then determines that 80% of the average fee is customary. Included in the survey are discount dental clinics and managed care facilities, which have severely reduced dental fees that bring down the average. Any doctor in private practice will have fees that insurance companies define as "higher than usual and customary".
Insurance companies do not recognize many routine and newer dental services. Our team will gladly assist you in filling out the necessary forms to maximize your dental benefits and discuss your financial options. Excellent dental care is available with or without dental benefits. We hope you choose the best dentistry has to offer.
Many plans confuse participants by giving the In-network as opposed to Out-of-network benefits. After reviewing many plans, the benefits only slightly vary between in-network and out-of-network. Before deciding on going to an in-network provider of your insurance, you need to evaluate the level of treatment and patient care you will be receiving. Our office only participates with Ameritas, Principal, Reliance, Security Life Dental and The Standard, meaning we are in-network with only Ameritas, Principal, Reliance, Security Life Dental and The Standard, but will file and accept assignment of benefits to any insurance.
What is assignment of benefits? As a service to patients, a dental office may accept assignment of benefits whereby they agree to have the patient request that his or her dental plan provider pay the dental office directly for the percentage of the cost covered. The patient is responsible for paying the co-payment when treatment is provided and any balance not covered by the insurance company. In some cases, a dental plan company will only reimburse the plan holder requiring the patient to pay for all costs at the time treatment is provided (Delta and BCBS are examples). In all circumstances, the patient is responsible for any costs not covered by his or her dental plan.