Dental Insurance FAQs

Q.  Do you accept my dental insurance?

A.  If you have a PPO dental plan, then yes! We’re an out-of-network dental office and PPO plans give you the freedom to stay in network or go out of network. HMO plans do not.

Q.  In-network vs. out-of-network dentists. What’s the difference?

A.  In-network dental offices are contracted with insurance companies. They are bound to treatment restrictions and pre-negotiated fees even if it’s lower than their usual fees. Out-of-network dental offices, like ours, choose not to be contracted with insurance companies in order to have greater control over the quality of patient care.

Q.  Why are you out of network?

A.  We firmly believe in uncompromising care. By choosing to be out of network, we can spend more time with you and treat you with the quality of care you deserve — free of restrictions placed by your insurance provider. When insurance companies put limits on our methods or approaches to best treat you and even on the quality of laboratories and materials we use, it’s simply not okay with us. We believe you should be the one to decide on the care you receive, not your insurance provider.

Q.  Will my benefits differ if I go out of network?

A.  Yes. Your coverage of benefits is set by your insurance provider and do differ between in-network and out-of-network dentists. Our patients prioritize freedom of choice, quality of care, and personalized treatment. While you may spend more, you get the freedom to choose who you want to see, greater access to specialists, advanced technologies and materials, and more personalized care.

Before making an appointment with us, please familiarize yourself with your PPO plan, particularly your out-of-network benefits. If you have any questions about your coverage, it’s best to contact your insurance provider. Having a clear understanding about your benefits before you see us will avoid any confusion after.

Q.  Will I know how much I am expected to pay?

A.  Absolutely. We value your trust above all else. That’s why we’re completely transparent about our fees. In advance, you’ll review and sign off on your treatment plan, our associated fees, and your estimated insurance reimbursements. Also, please keep in mind that our final fee could change if we discover anything that requires immediate attention and additional work during a procedure.

Q.  When do I have to pay for your services?

A.  At the end of your appointment, please pay for our services in full. Your insurance provider will reimburse you the applicable amount after they receive your claim.

We accept major credit cards, debit cards, cash, and personal checks. Also, you can make a secure payment with Apple Pay, Google Wallet, or PayPal.

Q.  Will you file my insurance claims for me?

A.  Yes, happily and quickly. To expedite your reimbursements, we’ll complete and submit all necessary forms to your insurance provider. Please understand that your coverage of benefits is a contract between you and your insurer, and matters of reimbursement are between you and them.

Q.  Do you offer discount plans and financing options?

A.  Yes and Yes. If you’re not insured, please check out our very own Discount Dental Plans designed to help you save and keep you on track with your oral health. If you’re interested in financing, no- to low-interest payment plans from CareCredit or LendingPoint may be good options for you. For more information, visit our page about Payment Options.

Q.  Can you summarize what dental insurance is and how it works?

A.  Sure. In the spirit of keeping it simple, here are some basic but important things to know:

Dental insurance helps cover the costs of dental care

If you have a dental insurance policy, you and your insurance provider share the costs. The percentages vary on the type of services. Your insurance provider predetermines what those percentages are and what is and isn’t covered. To maintain your coverage, you pay them a monthly premium.

You are not required to have dental insurance

In fact, some people who have excellent oral hygiene and get routine X-rays, exams, and cleanings elect not to buy it. They find that what they self-pay for these dental services compared to what they would pay for premiums plus their out-of-pocket share can be roughly the same or even less.

The quality of dental insurance policies vary quite a bit

You’ll find excellent, fair, and poor ones are out there. What your policy covers is based on how much you pay for it. Generally, the more you pay for your premium, the better your coverage. Likewise, the less you pay for your premium, the higher your out-of-pocket costs.

Dental PPO and HMO plans offer different approaches to dental insurance

A dental PPO plan offers you more flexibility. You can choose from a wider selection of dentists and specialists, including those outside of the network. Typically, you can see a specialist without a referral from your dentist.

With a dental HMO plan, you must choose a dentist within its network. It does not cover care outside of the network. Typically, you need a referral to see a specialist within the network.

Individual and employer-sponsored dental insurance are also different

For individual and family dental insurance plans, anyone can usually enroll but eligibility requirements can vary. Typically, you can enroll at anytime but some plans may have waiting periods before certain procedures are covered. If you belong to an employer-sponsored plan, you may have an open enrollment period to make changes to your coverage.

Q.  I have specific questions about my unique situation. Can I call you?

A.  Of course. We’re delighted to help you in every way we can. No question is too small so please call us and ask away!