Although the doctors at Aesthetic Dento-Facial Associates are not employees of insurance companies you certainly can be seen and receive benefits in our office. The dentists on your list are contractors of that company and are bound by the limitations of that particular plan. We provide experienced care and will work to maximize your benefits for the care you want.
Dental insurance is a highly desirable benefit which many patients use to reduce their dental costs. We file and help manage your benefits to maximize the benefit to you for the treatment you have chosen. In addition we will provide additional value to your experience by helping you pay for your deductible and copay in pre-tax dollars to the greatest extent possible. Please understand that the benefit you have is a contract with you and the carrier chosen and paid for by your employer. Benefits vary widely depending on the quality of the plan your employer has chosen. Each insurance company offers for sale many different policies with different coverage options. If, after you understand fully the benefit package you have and are not satisfied, contact your Human Resources department for a change.
Dental benefits are much different than your medical policy. Dental plans usually cover 25% to 40% of ordinary dental procedures. This is after deductibles, co-pays, and exclusions. Many dental plans are defined benefit plans, not insurance. Insurance companies are involved as they have the ability to enroll and process claims, but there is no risk to them. In fact, they may benefit by denying claims to stay under the amount budgeted by your employer. Whether indemnity or a defined benefit plan, fees quoted in your plan are generally arrived at by surveying fees in a geographical area and include discount dental clinics and managed care facilities, calculating an average fee, then further discounting that number and stating that this fee is “usual and customary”. Hardly. Quality care is a great value. The cost of quality dental care is never mentioned in statements about rising medical costs as this is not a factor.
An alternative way to manage your benefit which uses more of your money for your care is a “Direct Reimbursement Plan”. A number of school districts and businesses in this area use this method where over 90% of the funds involved are used for your care. You can see any dentist, all procedures are covered, no pre-authorization, no pre-existing conditions, and other desirable features are a part of these plans.. Ask your Human Resources about this as an alternative if you are not pleased with your present benefit scheme.
We have the ability to provide comprehensive, long lasting care in phases to allow you to use your benefits to achieve the high value outcome you desire, while maintaining your budget. There is great variance in the coverage and payment schedule from one policy to the next and yours will be examined by our experienced staff to advise you how best to proceed. In some instances patients have choices of one policy or another and we offer a free analysis to help you make the best choice for you as an individual. For example, if you want Invisalign orthodontics as an adult we must insure that your policy provides adult orthodontic coverage. If not, at your next selection opportunity, go to your Human Resources representative and request such a policy. This can save you up to two thousand dollars. This is just one example of how we can add value to your experience with us.
Your dental benefits are an important part of managing your health care funds. The procedures available in comprehensive dental care provide for a lifetime of improved health, well-being, and more youthful appearance. We look forward to the opportunity to help you.