POLICY AND GUIDELINES
Many of our patients request our assistance in the filing of Reno dental insurance claims. Reno Dental Associates is pleased to provide this service. We do, however, request the patient’s full portion of payment the day services are provided. We accept many Reno dental insurance plans and are preferred providers for many insurance carriers. This service is a courtesy to you, our patients. Keep in mind the contract is between the patient and the insurance carrier, and not between the insurance carrier and the dentist.
Ultimately, it is the patient’s responsibility to know their insurance company’s reimbursement schedules as well as their eligibility for coverage. The patient assumes responsibility for all care provided. Thank you for your understanding and compliance with these payment guidelines.
Questions or concerns about your insurance? Contact us for more information.
Dental Insurance Facts
Being an optimal-care dental practice, giving our patients the best possible dental service is something we strive for. While working towards this high quality of care, we wanted to provide you with some dental insurance facts.
The contract you have with your employer and the insurance company will decide on your dental insurance. In regards to your dental insurance benefits, it will be beneficial to get in contact with your employer or even the insurance company directly.
There is a huge difference between dental insurance benefits and traditional medical health insurance benefits. They can also vary from plan to plan. In the early 1960s is when dental insurance plans first emerged. Most of these plans had a yearly maximum of $1000. Now today, most dental insurance plans still have an annual maximum of $1000-$1500. With the premiums staying the same and allowing for the cost of inflation, your yearly maximum could be near about $28000 today. Although your premiums have increased, your benefits have not. With all of that being said, dental insurance was never created to cover 100% of your services. It was only meant to be an aid.
Your insurance company may be notifying you saying that denial fees are “higher than usual and customary.” These are known as UCR fees and insurance companies never disclose how they determine the “higher than usual, customary, and reasonable”. The state of Washington did a recent survey and found around eight different UCR fee schedules for a specific zip code in Seattle. These fees that they found were established by pulling “a percentage” of an average fee for a certain procedure in a specific geographic area. The average was explained as “the worst of the best” or “the best of the worst.” We do not provide average dentistry nor do we charge average fees.
There are several plans that explain to their members they will be covered “up to 80% or up to 100%,” but do not plainly specify plan fee schedule allowances, annual maximums, or limitations. It is more practical to anticipate that your dental insurance covers 35% to 50% of major services. Don’t forget that the amount a plan will be paying is solely determined by how much your employer paid for the plan. You will only be getting back whatever your employer has put in and less the profits of the insurance company.
Several routine dental services are not covered by insurance companies. Just because they are not covered does not mean that they are not necessary or appropriate.
We believe that dental insurance can greatly benefit a number of patients and we want to make sure our patients know we will do everything in our control to make sure you are receiving every benefit dollar you are entitled to. We will only recommend treatment and charge you based on your specific need, not your insurance coverage. The utmost decision as to what has to be done and how fast we move will always be decided by you. After you decide, we will talk about the overall cost of your treatment and what help you can be expecting from your dental insurance. Every arrangement is solely between you and our office. All of the responsibility for payments of services will always be with you.