Search Results for: insurance

PPO Insurance: Choosing an Out of Network Provider May Be Best for You

Yes, it is true that in-network providers sign a contract with PPO insurers. These contracts allow for marketing of the dental practices and create discounted fee schedules that in-network dentists must honor. In-network providers are not selected for the quality of care. So, why would dentists discount their fees to be in-network? Obviously, they need the marketing of their practices from the insurer? Perhaps the dental practice is new, perhaps the dental practice location is new, perhaps the dental practice is increasing their number of dentists, and perhaps patients are not referring back to the practice as much as is

Dr. Mark Venincasa January 23, 2022

Dental Insurance and Saving Money on Dentistry

Many patients think that going to a dental office that is listed on their dental insurance plan is going to save them money. This is understandable. These listed dental offices, in exchange for being listed and “preferred,” accept a significant hit to their profit margins due to fee contracts they sign with the insurance companies. Do you think this hit to their profit margins benefits you, and saves you money? We have had too many patients who have come to our office wanting a second opinion, because they were told they needed a “deep cleaning” for the first time ever,

Dr. Mark Venincasa June 10, 2019

Insurance Plan Dentists: Finding a Dentist

Many patients for different reasons find themselves in a situation of finding a dentist. Quite a few of these patients have a dental insurance plan which offers a list of “preferred providers.” This sounds like an easy way to find a dentist, right? Well, the truth of the matter is that these dentists or dental organizations enter into a contract with the insurance companies to be listed as “in network,” or to be listed as “preferred providers.” By signing this contract, the dentists are caring for patients at a discounted fee. The fees may be decreased as much as by

Dr. Mark Venincasa August 30, 2017

Insurance Plan (PPO) Dentists: Can They Afford to Be Conservative in Their Care?

Insurance plan dentists sign contracts to accept maximum fees that they may charge to their patients. While this may sound great for patients, the downside is that the fees much more closely approach the cost of doing business. In other words, the profit margins are significantly decreased. Why should this matter? Profit is bad, right? Profit is not a bad thing. They contribute to income, viability, and improvement of a dental office. It is excessive profit that many have a problem with. I am not talking about that. So with the profit margins being squeezed significantly by the insurance companies,

Dr. Mark Venincasa August 10, 2017

Insurance Plan Dentists: Choosing a Dentist

Many patients look for a dentist on their insurance plan. Patients are looking to decrease their out-of-pocket expenses. This makes sense. However, when you are choosing a dental office with a “cute” name, are you truly choosing a dentist, or are you choosing a retail or corporate entity? What does it matter? The delivery of dental care has changed immensely over the past 30 years in which I have practiced dentistry. There used to be a time when a dentist would put his/her name on a “shingle,” an old-school saying, and hang it over or near their door. There was

Dr. Mark Venincasa May 16, 2017

Obamacare 2015 Update on Dental Insurance Coverage

We have discussed the subject of dental insurance coverage within Obamacare quite a bit in previous posts. To summarize, dental benefits must be made available for purchase to cover children. So, dental coverage is not mandatory per Obamacare. This dental insurance coverage may be included within a medical plan or through a separate stand-alone dental insurance product. For the year 2015, there have been some changes to enhance options and access for dental services. We now present some bullet-points to describe some changes and facts on Obamacare related to dental insurance coverage: The ADA Health Policy Institute has found that

Dr. Mark Venincasa March 26, 2015

Private Individual Dental Insurance Plans

Over the years it has been common for us to be asked about the value of private individual dental insurance plans. Patients who have no dental insurance think about this as an option to paying for all the fees on their own. These plans tend to be a compromise to the group plans often offered by employers. The decision on purchasing one of these plans is an individual one; however, as indicated, these are a compromise. For the lower premium plans, patients may have the option to pursue their own dentist even out of network. These plans may also pay

Dr. Mark Venincasa August 21, 2014

More Facts on Obamacare (ACA) and Dental Insurance

We continue to offer dental insurance information for you, our patients and prospective patients, within Obamacare. We recently found some basic information concerning dental insurance. Under the Affordable Care Act (ACA), or Obamacare, we all know that health coverage is mandatory for most people. However, when it comes to dental insurance coverage things are a bit different. Obamacare mandates that children (aged 18 and under) must have dental insurance coverage “available”. However, obtaining dental coverage for children is not considered mandatory to avoid the penalty. Children do not have to have dental coverage although they must have health coverage for

Dr. Mark Venincasa June 30, 2014

Choosing an Obamacare (ACA) Dental Insurance Plan

We realize there is still much information that is not yet defined under Obamacare, the Affordable Care Act (ACA). We do have patients asking us questions about it. We understand that for many it is a requirement to obtain an ACA plan. We also understand that many individuals are not familiar with choosing a dental plan at all. That is the purpose of this post; we want to offer some information on selecting an ACA dental insurance plan. We have heard our president in the past indicate that you can “keep your doctor”. Perhaps we can extrapolate this to being

Dr. Mark Venincasa May 26, 2014
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