This is a tricky question which I hear nearly every week. The short answer is that I do not take dental insurance, but my office will bill and submit all the paperwork to your insurance company and they will reimburse you depending on your plan, the procedure being done, and your yearly maximum. For an explanation, please read on.
A dental office has the option of “Participating” with a dental insurance company. If they choose to do so they sign a contract saying they will charge set fees for certain procedures. The insurance company then agrees to pay a certain portion of those fees based on the specifics of your dental insurance plan. This creates a new dynamic in the office. Alongside the doctor-patient relationship there is also a patient-insurance and a doctor-insurance relationship. Dental insurance is a ~100 billion dollar a year industry. For them to be profitable they must pay out less than they take in. In other words, they fight to raise premiums and lower reimbursement. In my experience, when dentists agree to charge only what insurance companies reimburse they are forced to
(1) see more patients in a day
(2) spend less time with each patient
(3) pinch pennies when it comes to dental materials and technology and
(4) partner with an affordable dental lab.
Furthermore, dental insurance is not like medical insurance. Only a select number of preventative and essential procedures are covered and rarely at 100% coverage. There are also yearly maximums between 1000-2000$ based on your plan. Don’t get me wrong, this dynamic is very successful, and leads to a tremendous number of people every year receiving affordable, and often excellent care.
So why did I choose not to participate? I make promises to every one of my patients whether they are receiving a cleaning or a whole new smile. I promise to listen and explain to the best of my ability. I promise to focus on you and only you when you are in my office. I promise to use top of the line dental materials and technology. And I promise to partner with premier, cutting edge dental labs. For these reasons, I have decided to do away with any ties to insurance companies.
Once you come in for a consultation, you and I will discuss treatment options and treatment plans. My staff will itemize the plan and present the associated fees. We can also submit this plan to your insurance company to see what they will reimburse you once it is completed. If you decide to move forward, you pay for the procedures, and once the procedures are completed, you receive a check in the mail from your insurance company roughly 2 weeks later. If you do not choose to move forward, I am more than happy to let you keep the treatment plan we laid out and refer you to a number of excellent general dentists in the area who might take your insurance.