The complexities of dental insurance can create confusion for many parents. Additionally, the lack of sufficient information provided by some insurance companies makes it difficult for some to properly understand their benefits. We hope the information provided here will help you work with your dental insurance company to achieve the highest level of benefits to which you are entitled.
What is Dental Insurance?
Dental insurance is a contract between your employer and a dental insurance company. The benefits that you will receive are based on the terms of the contract that were negotiated between your employer and the dental insurance company and not your child’s dental office. The goal of most dental insurance policies is to provide only basic care for specific dental services. The services selected are based on the costs of the policy to your employer and the negotiated arrangements with the dental insurance company. The benefits that you receive from the dental insurance for your current insurance plan have nothing at all to do with you, your child or achieving a high-quality, complete result. Because the benefits your currently have are decided between your employer and the insurance company, many services are not covered. The selection of non-covered services is not based on what you need or want, but is based strictly on the contract with the insurance company. Dental insurance companies rarely cover 100% of any dental fee and in may cases cover less than 50% or nothing at all!
Covered and Non-Covered Services
Unfortunately, some of the services that your child may need or want will not be covered by your dental insurance. Our goal is to help you achieve and maintain optimal dental care for your child, which is not necessarily the goal of your dental insurance company. The goal of the dental insurance company is to provide only the negotiated benefits for the specifically selected services.
The reimbursement mechanism from your dental insurance company is merely a mathematical formula as to which benefits you will receive and the percentage of the fee that will be paid. We do not want to compromise your care based on restraints placed by an insurance company.
Another fact that most parents do not realize is that most dental insurance plans have a dollar amount limitation each year. Once this limit is reached, no other services will be covered by your dental insurance company regardless of how essential the service may be to your child!
Filing Insurance Claims and Prior Authorizations
Our office will complete and submit insurance claims on your behalf. Please be aware that some dental insurance companies take longer than others to issue payment. If your dental insurance company has not issued payment within 30 days of service (as required by Minnesota State law), we ask that you pay the balance on your account and when/if your dental insurance company issues a payment, you will be reimbursed. If you would like our office to submit a prior authorization on your behalf, please let us know.
Our office remains dedicated to providing optimal care for every patient and working with your to achieve that goal. We pride ourselves on helping you in any way and in continuing to provide the quality of care to which you have become accustomed.
Please let us know if you have any questions — it will be our pleasure to help you.