#1 "Do you accept my insurance/What will my insurance pay?"
YES, we accept and file with most insurance companies (the exception being Medicaid/Medicare)! Just as every patient is different, so is every insurance plan and its' benefits! It's important to note that while the insurance plan that you or your employer chose may pay for bi-annual hygiene cleanings, fluoride treatments, cosmetic services, or restorative care (crowns, root canals, bridgework, etc.)--every plan is completely different and may change without you being notified. Remember, having dental insurance doesn't mean your dental work is free or always paid for by your insurance plan (more on that in the next Q&A!).
If you don't know the details of your plan, our expertly-trained staff can assist in explaining what procedures your particular plan provides and give you a general idea of what to expect to pay at your appointment. This valuable benefits summary is a personalized service that helps our patients understand the often complex details of their insurance plan! If you do not have dental insurance, don't worry--you're not alone! In fact, in 2016, over 74 million Americans did not have dental insurance (Source). We have many patients with a restricted dental plan, Medicaid/Medicare plan, or have no insurance at all who pay at the time of their services or take advantage of CareCredit convenience.
MOST IMPORTANTLY, don't delay your hygiene appointments! National reports prove that you're 67% more likely to have heart disease, 50% more likely to have osteoporosis, and 29% more likely to have diabetes without regular hygiene care. In addition, you're more likely to have extractions & dentures and less likely to have restorative care or receive treatment for gum disease (Source)!
#2 "What does being an ‘Out-of-Network’ provider mean?"
As Martha Stewart would say, "It's a good thing"! Since Dr. Gravitte began in private practice over 14 years ago, he made the decision to put his patients' care first and remain out-of-network. This means he chooses the "standard of care" (insurance lingo-not ours!) for the patients of his practice. Many patients (and many offices) do not realize that by signing on as an "In Network" provider, the Dentist fee schedule and services for what can be "covered" is controlled by the insurance companies. This determines which "covered" procedures customers can have based on their insurance plan--EVEN if it's not the best treatment for the patient. Yes, dental insurance companies can choose which procedures they allow to be covered by their in-network Dentist!
Many patients and insurance companies have requested we join their particular network and become an "In-Network" provider for their specific insurance. Remaining out of network allows us the ability to provide you with an uncompromised level of quality dentistry and patient care. As a courtesy to our patients, we still accept and file your claims for nearly every insurance company.
We choose to share this information with our patients because many people may think "out of network" is a bad thing or that they can't join our practice. Actually, it means that we can provide our patients with the very best dental care!
#3 "My employer just changed our dental insurance provider- What do I need to do?"
In most cases, there is nothing you need to do now except make sure you keep your six-month dental hygiene appointment. Of course, we will need your new insurance card at your appointment, but contact us before your appointment so we can perform a new complimentary benefits summary to make sure you're taking full advantage of your dental benefits your new plan offers, without any of your annual benefits expiring!
If you’re wondering what's new?
There may be changes you aren't aware of yet. For example, (and remember every patient/plan is different):
There are insurance companies whose policy is to "directly reimburse" (again, insurance lingo-not ours) the policyholder with the payment for the dental services--instead of paying the dental office. This means the insurance company will send the check for our dental services directly to the patient, NOT the dental office for services and treatments. If this is the policy of your dental insurance company, it is your responsibility to pay for your services at your appointment. For your convenience, we will still file your insurance claim, and then your insurance company will reimburse you or the policyholder directly.