Insurance and Payment Info

Dental Insurance is Not Like Any Other Insurance; It Is Worse!

dental insurance PPO quality providerDental insurance has been in existence for over 40 years.  Over that time the annual maximums that these plans will pay out has not increased appreciably at all.  Many dental insurance plans still pay under $1500 annually.  These dental plans do not keep up with inflation at all; if these plans did keep up with inflation they would allow an annual maximum of about $7000. 

Let’s compare dental insurance to car insurance.  Let’s say these car insurance plans would only pay about 25% of the value of your car just prior to its being “totalled”.  How would you feel if the check you received to replace your totalled car was only about 25% of what that car was truly worth?  That is exactly what dental insurance has done; the benefits have been reduced that severely.   This same scenario can be compared to home insurance, life insurance, jewelry insurance, etc….  Clearly dental insurance is not at all like all these other insurances.  We all may have seen in the past 40 years the price of gasoline increase from 29 cents a gallon to about $4 a gallon.  Why hasn’t dental insurance allowed for inflation as well?

As these dental insurance carriers do not keep up with inflation, they can perhaps decrease insurance premiums to enhance their sales.  However, in doing this, the quality of dental care is not a consideration for them.  Another way dental insurance plans can decrease premiums is by creating PPO’s, or Preferred Provider Organizations.  In creating these PPO’s, insurance carriers shift the burden of decreasing costs to the dentists who have signed on their plans.  These dentists accept charging their patients lower fees in exchange for having their practices marketed  to employees covered by these PPO’s.  By accepting these lower fees, dentists are “squeezed”.  They must do business in such a way to decrease their costs, which may sacrifice quality of care.  Again, the insurance carriers main interest is to decrease their cost irrespective of the quality of care patients receive.  So these “managed care” plans should more properly be described as “managed cost” plans because that is truly all they are doing.  These PPO-type plans also limit a patient’s ability to select the dentist they desire since these plans contract with a smaller segment of the dentist population.  However, patients may choose dentists outside their PPO plans.  The benefits paid for going outside of the network of dentists may be less. 

In my practice we have had quite a few patients leave our practice to “reduce their costs” by going to an in-network PPO dentist.  However, many have come right back after experiencing these PPO practices, finding that my practice is run much more efficiently, kindly, and with an emphasis on superb personal care and service.  We invite you to experience dental care the way it should be provided.  We invite you to make an appointment with us by calling (972) 250-2580. 

Why We Don’t Sign a Contract with a Managed Care Insurance PPO

We realize many of you have a managed care Preferred Provider Organization (PPOPPO insurance managed care discount dentistry low fee) type of dental insurance plan.  For years we have refused signing on the dotted line with any insurance carrier and I will tell you why right now.

When dentists sign the contract with a PPO, they accept fees for their services which are much closer to the cost of providing those services.  Yes, they are accepting a lower profit margin.  While profit may seem like a bad thing for some, it is company profits which pay for anyone’s salary.  Without profits, employees do not get paid; yes, we all understand that salaries are a business expense but they do come from monies earned from performing business.  So, why would a dentist accept lower fees approaching the cost of providing services?

In return for signing on the dotted line, these managed care dentists have marketing provided for them free of charge from the insurance company and from the employer human resources departments.  This marketing drives employee-patients into their practices without regard to the quality of care delivered.  These dentists may desperately need this free marketing because their practices may not be very busy; these practices may be very new or these practices may simply not be able to attract enough quality patients on their own.  For some of these practices providing discounted dentistry is thought to be better than having open appointment times.

To enhance profit margins these managed care dentists may manage their dental business differently.  They may have a lower paid staff, they may double-book appointments, they may pressure patients to receive care, or they may contract with an overseas or deeply discounted dental lab.  These labs make crowns, bridges, dentures, partials, and other appliances for patients.  These discounted labs may use off-brand materials and they may employ lesser-skilled technicians.  Since many of these managed care dentists may also have full paying patients, they may ration managed care patient appointments to reduce their losses from the lower fees being paid.  This means patients may need to wait longer to get their care.

Don’t you see?  In order to create a larger profit margin because managed care dentists receive lower fees, they may sacrifice their quality of care or they may sacrifice their respect for your time.  Either way you may lose.  And you really only have one set of natural teeth.  Do you really want to have discounted dentistry done in your mouth?  Is it worth the potential risk?

While going to a more traditional dentist does not guarantee anything, I can say that I have established my practice to be able to provide very nice care at a value fee.  No, we do not have the lowest fees; however, our quality of care and service is no where close to the lowest.  Our fees are also not the highest; we want to provide high quality care for all patients at a reasonable fee.   We honestly have patients return to our practice after feeling pressured financially to seek care from a managed care dentist; they often realize our services are so much more personal, caring, respectful, and quality-oriented.

We understand patients want to save money.  We assist patients in saving money by being honest, by providing only care that is needed or desired, and by doing dentistry in the right way without “cutting corners” or sacrificing quality, care, service, and respect.  We also have creative options for patients to make payments over time.  We treat all our patients with the same respect and care; we do not distinguish between full-paying patients and managed care patients.

If our practice sounds more like what you want for you and your mouth, we invite you to contact us at (972) 250-2580.  We invite you to see just how unique we really are!

Making Dental Care Affordable with Flexible Payment Options

affordable dentistry, financing, payments, insuranceJust as you are we are living this life.  We do understand that many people experience difficulties.  We do understand that financial situations can change suddenly.  We do understand these sudden changes many times are not under any control we may have.  We do understand!

We also know that dental care that is avoided over a period of time can become substantially more involved, can become substantially more expensive, and at times may lead to irreversible damage.  For these reasons we have much in the way of empathy and sympathy.  We really do.  Clearly we are in business to help any of you who enter our office.  We want to create a win-win situation which allows our patients to obtain care they need or want, affordably, and which allows us to continue to provide our unique mix of quality, personal care, honesty, respect, and kindness.  So how can we help?

We have worked very hard to offer many ways for patients to pay for dental services.  We allow payments from insurance plans to post to our patient accounts, which decreases our valued patient’s out-of-pocket expense.  We allow payments by multiple major credit and debit cards, we allow payment by flexible spending account credit/debit cards, we allow payment by check and cash, and we assist our patients with financing options. 

With our financing options, patients can pay for up to 12-18 months interest-free, or they may extend their payments over a longer period of time with interest.  For those of you who have encountered some financial difficulties, we still have ways of providing the dental care needed or wanted with a relatively low down-payment, with payments over a period of time with interest.  There is much flexibility here.  We want to help make dental care achievable and affordable.  We do indeed care that much.  We invite you to fill out a secure application if you are indeed interested.

If we can interest you in these kinds of discussions, we invite you or someone you know to contact our north Dallas office at (972) 250-2580.

We Do Accept Many Insurance Plans 

Dallas dentist Plano Richardson Addison insurance accept assignmentMany of our patients have dental insurance.  We are pleased to help you in managing your claims.  We do accept payment from your insurance carrier.  Even PPO insurance plans offer valuable “out of network” benefits that can be used to pay for our services.  You will find that we do all we possibly can to provide an accurate claim in a timely manner to your insurance carrier.  You will also find that we “go the extra mile” to make sure your carrier is providing good service to you.  Our patients value the way we can obtain a quick turn-around time with the highest benefit amount in an honest manner.  We do work with many insurance carriers; most commonly we work with MetLife, Aetna, Cigna, and United Healthcare.

Payments by Patients

Dallas dentist Plano Richardson Addison payment plan interest free installment

We have made payments easier for our patients by accepting cash, personal checks, Visa, MasterCard, American Express, and Discover.  In order to keep our fees reasonable we ask that payments be made at the time that services are rendered.  We are much better at dental services than we are at banking services.  However, for those of you who need a means to make payments over time, we do offer CareCredit. 

CareCredit: Interest-Free and Extended Payment Plans

Dallas dentist Plano Richardson Addison CareCredit financing interest free

 

With CareCredit, approved patients can make payments over time.  Interest-free payment plans can be obtained for up to 12 months.  Extended payments plans can be made for up to 60 months at a CareCredit informationrate of 13.9%.   Our patients appreciate this ability to make payments over time.   At the same time we can maintain reasonable fees since we are allowing CareCredit to manage the patient financing for us.  We honestly believe this is a positive way of doing financing for our patients.  For those of you with dental insurance please view this short video; click here.  For those of you without dental insurance please view this short video.

 

Treatment Planning and Financial Arrangements 

Dallas dentist Plano Richardson Addison affordable simple paymentsBefore we initiate any treatment, we work very hard to explain treatment options along with their advantages and disadvantages.  Following that, we present to our patients the fees, as well as our estimate of how insurance may pay as well.  In that way patients have an estimate of their out-of-pocket dental expense.  While we work very hard to make these estimates accurate, dental offices at this time still cannot have instant access to the databases of individual insurance carriers for determination of benefits.  As a result, we may only provide good faith estimates for which we cannot be held accountable.  We do the best any dental practice can to provide accurate insurance information.

 

Insurance Plans Refusal to Pay for Crown Buildups

Dallas dentist Plano Richardson Addison crown great durable long lastingCrown buildups are basically fillings that are provided on teeth that are to be covered with a crown.  There are many advantages to providing a crown buildup.  However, many insurance plans are attempting to deny coverage for them.

The reason why crown buildups are done are numerous.  First of all, buildups are like artificial tooth structure which allow the crown to hold on better.  As a result the crowns have less of a chance to fall off.  Secondly, buildups are insulative and contain fluoride.  As a result they protect the tooth from temperature changes and from decay.  Lastly, buildups can have a medicinal quality that allows the nerve tissues of the tooth to respond favorably to treatment.  There is no doubt that dentists who regularly perform crown buildups are more quality oriented.

However, even though buildups have many advantages and are quite necessary to acheive the best result, many insurance plans are unwilling to provide benefits for them.  Some insurance carriers indicate that the buildup is part of the crown and is not a separate service.  This is not true.  Buildups are made of a totally different material that the crown is.  Physically they are distinct and separate.  Moreover, buildups are an additional procedure that is separate from the procedures done to make a crown.  Similar logic would be that lifetime termite coverage is part of the service homeowners receive when they purchase a home.  Clearly the two are totally separate and are not intimately related.  This same relationship exists between buildups and crowns.

If you find that your insurance carrier is denying the crown buildup, we would recommend that you contact your insurer directly to indicate your displeasure.  If enough employees contact the insurance carrier and their human resources department, then perhaps the buildups would be covered more readily.

For one last point, some carriers will pay for the buildup if it is done on a day separate from the day the tooth is prepared for the crown.  Procedurally this makes no sense at all.  The buildup must be done prior to the crown impression in order for the crown to be made.  Moreoever, it makes no sense to do the buildup on an appointment date prior to the appointment in which the crown is prepared and impressed.  That creates an additional appointment and adds another event that may potentially adversely affect the tooth. 

We sincerely care about our patients and the quality of care they receive.  We will always care more than the insurance carriers will.  If you have any questions about this please do contact us.  If you have an interest in a dentist who cares very much for his patients, we invite you to contact us as well.

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