Insurance

Frequently Asked Questions

"Do you take my insurance?"

Our practice is a preferred provider for many dental insurance companies. The list provided shows the companies we are in-network with. We accept and work with ALL insurance companies and our office understands that dental insurance can be very confusing! Every plan is different, making it difficult to know what procedures are covered and how much the company will pay. Our front office staff will make every effort to help you maximize your plans benefits.

"What does UCR mean?"

Usual Customary & Reasonable - Insurance plans pay an established percentage of dentists fees. It's a payment for dental services based on a geographical area and what other dentists are charging in that area for similar services. Although they are called "customary" they may or may not reflect regional data that is up-to-date or even accurate. There may be huge differences in the companies reimbursement rates because insurance companies have no regulation.

"What is a plan maximum?"

Every insurance company has a yearly (usually starts with the new calendar year, January 1st, and runs to December 31st) maximum. The company will most likely have a dollar limit for each patient, and pay for services up to that amount. Although the cost of living has increased significantly over the years, most dental maximums have not changed since the 1960's! The majority of plans will pay up to $1000, but there are a few that have higher (and some lower) maximum rates, and they can vary on date ranges.

"What is a deductible or a co-pay?"

Most plans have an out-of-pocket payment such as $25 or $50 that will have to be paid before actual service receives payment. It should be paid at the time of the appointment.

"Will my insurance pay for all the services I need?"

It is very rare to have an insurance company pay for EVERYTHING. Some companies downgrade services such as "white" composite fillings vs. silver amalgam fillings. There are some services that will not be paid AT ALL. To avoid misunderstandings over large treatment plans and how much your insurance coverage will pay, our office will send "pre-estimates" (or prior authorizations) before your treatment to get an idea of what you payment portion will be. We have consultations and financial discussions before treatment so there are no surprises! There may be "pre-exsiting conditions" or certain treatment exclusions that result in no payment from the company. Insurance contracts are agreements between you, the patient, and your company. The coverage is based on your negotiated contract and its terms and regulations. It is the patient's responsibility to know and understand their plan's maximum, benefits and limitations. We are here to help you make sense of your plan and help you get the maximum benefit so you can accomplish your dental health goals.

© 2023 by Ray Klien. Proudly created with Wix.com

Dr. Kent A. Caserta

Family Dental