Introduction

      On the day of your consultation you were given information regarding the charges for the procedures you will be having done in our office. It is important for you to know what your insurance policy covers. We recommend that you check with your insurance company if you have any questions regarding your benefits. Due to the growing number of insurance companies and plans available, it has become difficult for us to call and verify insurance coverage for every patient. We have found the phone policy of many insurance companies to be that they may only verify general benefit information to the doctors office. They usually cannot quote exact procedure fees, so we are not able to calculate the exact amount that your insurance will pay. You will want to be aware that any information received by phone from an insurance company is not a binding agreement for payment.

      We are happy to file your insurance claim forms for you the day of your surgery to assist you in receiving the benefits your insurance company has contracted to provide you.

Key Questions

Key Questions to Ask Your Insurance When Verifying Your Benefits:

1. Yearly policy maximum
2. Benefits used so far in your calendar year
3. Calendar year dates
4. Usual and customary fees foe the procedures you are having done
5. Is general anesthesia a covered benefit for the procedures you are having done?
6. Percent of coverage you are currently at.
7. Verify class code of procedures you are having done (extractions are usually Class ll)
8. If you have two insurances, does your plan have a non-duplication of benefits clause?
9. Age limit for dependent children
10. Student verification requirement

Other

Pre-Determinations

If you or your insurance company requests, we will submit a pre-determination to your dental insurance to help you verify your coverage before surgery.Results from pre-determinations may take anywhere from 3 to 6 weeks depending on your insurance company.

Benefits That May Not Be Covered By Your Insurance:

General anesthesia for extraction of erupted teeth (codes 07110 and 07120), Surgery erupted teeth (code 07210) and residual tooth roots (code 07250).

Having general anesthesia may be in your best interest for the type of surgery you are having, but it may not be a covered benefit by your insurance.

Medical/Dental Plans

Medical Plans/Networks:

1st Medical, Aetna, Amerigroup, Blue Cross/Blue Shield Medical, Beech Street, Coventry, Galaxy Health, Great West, Humana Medical, Kaiser, Medicare, Multiplan, One Health Network, PHCS Network, Preferred Plan, Railroad Medicare, Southcare PPO, SuperMed, United Healthcare Medical

Dental Plans/Networks:

Aetna Dental, Affordable Dental, American Dental Plan, AmeriPlan Dental, Ameritas Dental, ASP Dental, Assurant Dental, Avesis Dental, Blue Cross/Blue Shield PAR Dental, Careington Dental, Cigna Dental, CompBenefits Dental, Connection Dental, DCare Dental, Delta Dental, Dental Directory Services, Dental Health Alliance, Dental Networks of America, Dental Plans.com, Dentemax Dental, Denticare Dental, Doral Dental, Fortis Dental, Geha Dental, Guardian Dental, Humana Dental, Metlife Dental, NHCD, Principal Dental, Protective Life Dental, Unicare Dental, United Concordia Dental

If you do not see your particular plan/network listed, please call our office. Participation with plans are subject to change.