Patients with Dental Insurance
We are pleased that you have a dental co-payment insurance policy. We will do everything we can to help you maximize your benefits on a yearly basis. We work with and accept reimbursement for most major insurance carriers, unless it is an HMO/DMO (you can’t choose your provider), and we are happy to file these claims on your behalf. We do collect any applicable estimated copayments at the time of your appointment, and this amount will be discussed with you prior to scheduling your appointment.
We ask you to keep several important facts in mind:
- The amount a dental insurance plan pays is determined by how much the Employer paid for the plan.
- Considering fee schedule allowances, annual maximum or limitations, it is realistic to expect dental insurance to cover 35 to 50% of major services.
- Dental insurance companies do not cover many routine dental services.
- Dental insurance companies do not guarantee payment of services, even when benefits have been verified and pre-treatment estimates submitted and processed.
More About Dental Insurance
You have a maximum coverage per year of $500, $750, $1000 or $1500. When dental co-payment plans began in 1970 they allowed the same amount of maximum payment per year as allowed today. In other words, reflecting for a 6% per year inflation, your $1000 annual benefit is equal to $290.00 in today’s dollars. Had the various dental insurance companies increased their benefit on a year-by-year basis reflecting increases for inflation, this year your benefit would be $3207.14 per year.
We ask that you understand we neither work for the insurance companies, nor do we wish to. We work 100% for you! We want to help you maximize your benefits, but also we do not want to compromise your dental health by letting your dental insurance control your treatment options.
You may receive a notification from your insurance company stating that dental fees are "higher than usual and customary". Insurance companies survey a geographic area, calculate an average fee, take 80% of that fee and consider that to be customary. Included in this survey are discount dental clinics and managed care facilities, which bring down the average. Because Dr. Valentine practices comprehensive dentistry utilizing high-quality materials and laboratory products, our fees may be higher than "usual and customary".
Although we work with most major dental insurance companies, we are not in-network with any dental insurance company.
"Our mission is to provide high quality comprehensive oral health care based on mutual trust in a safe, comfortable, and friendly environment while maintaining a high standard of ethics. It is our genuine compassion for people that ensures our patients receive optimal oral health care and remain our highest priority."