DENTAL INSURANCE REPORT

Are You Being Ripped Off by Your Insurance Company?

Insider Tips To Help You Save Time and Money

A lot of people are curious about the mysteries of their dental insurance coverage. Surprisingly only a handful people really know what their insurance covers and how to maximize these benefits. Here is a special report that covers everything you must know about your insurance coverage.

Some of these information are concealed from insurance holders by the insurance companies themselves. Why? Money speaks volumes. Insurance companies love cashing in the checks you or your employer pay you monthly, however they also love holding on to that money the longest time possible. This means, they would sometimes withhold information to keep you from knowing exactly what your policy covers. In short, they want you to end up getting a less expensive treatment or end up paying for the dental procedure yourself. Sounds vicious? Sometimes it can be that way.

Dental insurance is still important

We are not saying that signing up for dental insurance is something that you can skip. We discourage that, but knowing your benefits and how to maximize it are the things everyone should know, especially during these hard economic times. With that said, you must carefully read over the terms of your insurance coverage. Know what it covers, if all else fails, contact your trusted family dentist so they can help you in understanding what you are covered for and how much your insurance will cover and what needs to be paid by you.

Questions your dental insurance carrier is afraid you will ask

To save you the money and time, ask these questions from your insurance carrier.

• How long does it take to completely process a claim and how is it processed?

In most dental practice, insurance claims are processed are filed electronically. The great thing about filing the claim electronically is that the process is dramatically sped up. In most cases, claims are processed and paid within 30 days. In some states, insurance companies are required to process all claims in 30 days. If not, policy holders can file a litigation case against the insurance company.

• Is there any annual deductible? If there is, how and when is it applicable?
• Does it cover the whole family, or is it individually applied?
• Is there any dental procedure where the deductible does not apply? (Ask for the CDT code.)

The deductible is the amount dental premium holders pay before the insurance company pays for the benefits. There are two types of deductible family and individual, you must meet the deductible on the policy before your insurance company cash out payments for procedures. There are instances when the deductible is waived by insurance companies, in most cases these are for preventative procedures.

• Does the plan involve any waiting period for any dental procedures before the plan takes effect?
• If so, how long is the waiting period and which dental procedures require this?

Get specific answers from your carrier and get the CDT codes if possible. In most cases, waiting periods apply on costly dental procedures such as dental crowns, bridges, and dentures. On average, waiting time can extend from 6 months to 12 months depending on your insurance carrier.

• Is there any dental procedure that is excluded from your policy?
• If so which dental procedures are these? If possible ask for the CDT Codes.

There are certain dental procedures that your insurance carrier will not cover. For instance, many insurance carriers will only pay for metal fillings (silver) instead of colored fillings (composite). This happens although most states encourage dentists to use colored fillings instead of metal fillings.

• Who do I contact for information that I require regarding my insurance benefits?
• If I have any questions pertaining to my insurance plan?

You should find a phone number on the back of your insurance card, or you can also contact them on their website.

• In what percentage does my plan cover all dental procedures?
• Are there any dental procedures where I get lesser from the real amount that I pay?

In some cases and procedures, your insurance company will only reimburse you with a portion of the full amount that you paid for a service. It is very important that you ask your insurance agent specifically for the percentage of the reimbursement that you can expect from certain procedures. Through this, you can get a solid grasp on how much you can expect to receive from your insurance company. This way, you do not over spend on certain procedures that can done with an alternative procedure with higher payout instead.

• How much is the maximum annual plan benefit can I or any of my family member use?

In most cases, each family member will have a coverage of between $1000-$2000. Sadly, this amount had never increased in the past 15 years (a fact most insurance carrier will hide from you). Although this is the case, it's better to have a good idea of how much your coverage is yearly, so you do not spend over your annual benefit.

We hope you found this information helpful. There are many dentists who follow the insurance policies exactly and are not concerned about your best interest- they are mainly interested in being reimbursed. To get the best quality of care, and the most benefits out of your insurance, you want a dentist who will “go to bat” for you, and help you fight for the best care. Sometimes this is a dentist that is not contracted with the insurance company. Not being contracted gives them the right to negotiate with the insurance company in your best interest. There are many dentists who will do this, and one of them is located in Charlotte NC. Ballantyne Center for Dentistry will do their best to work with your dental insurance company to get the best quality of care for you.