One of the most common problems dental practices run into has to deal with dental insurance. Most often than not, patients don’t understand the policies of their insurance or how their coverage works. What happens when we don’t understand our policy? When we don’t fully comprehend what our benefits, it’s easy for us to assume we are covered or that dental offices should be should know our policies. However, insurance policies all differ and is dependent on the plan we pay or our employer pays, if they provide dental benefits as part of their compensation package. Before visiting the dental office, you want to get familiarized with your policy to fully comprehend what it will cover and what you will have to be responsible.
Tips to Familiarize Yourself with Your Policy
Whether it’s insurance you bought or benefits your employer provides, ask for a copy of your policy. Your policy is your ticket to understanding how your benefits work. There are a couple of things you want to keep in mind, and that’s dental insurance is not medical insurance, they are separate and work differently. Dental insurances don’t cover cosmetic procedures or pre-existing conditions, and they have a 100-80-50 coverage. These are good to keep in mind as we read through our policies. Here’s what you want to look for as you read your policy.
☐ Deductible – what you have to pay if any before your benefits start to cover.
☐ Covered Services Lists – a table which lists both the service and amount of dollars the plan covers (it will allow you to determine the difference you will be accountable for paying if the dentist fee is greater than the fixed amount).
☐ Annual Limitations – there are yearly maximums to how much coverage you will be given in the year whether it is cost or amounts of procedures (it can help contain cost and maximize benefits).
☐ Preferred Network – some dental insurances only cover services provided by dentists in their preferred network (you want to ensure whether this applies to you; otherwise you will have to pay out-of-pocket).
We want to be aware of all four key elements above to ensure we minimize the costs of treatment and to make the most of our insurance. Reviewing our policy and highlighting key points will not only allow us to pinpoint the details we miss but will enable us to address it if our insurance isn’t willing to pay for it.
In a case where we might in to file a dental claim, we need to get into contact with our insurance to know how to submit one and get notifications on the status of our claim. Some dental practices, not all, offer to file dental claims as a service; however, they are not responsible nor required to do. We need to acknowledge dental offices are not required to submit claims for us but provide us with the necessary documents to file one to get it reviewed soon.
At The Center of Dental Professionals, we can assist you in filing a claim or even submit the dental claim for you, but we do ask our patients to be aware of the status of their claim process. Contact us for any questions, feel free to call us at 801-505-7125 or if you looking to see if we accept your dental insurance go to our INSURANCE PAGE to see if your insurance is listed.