Insurance and Financial Info
At Implant Dentistry and Periodontics, your smile is our number one priority. As a specialist in implantology and periodontics, Dr. Michael Edwards can help patients replace missing teeth with dental implants as well as treat gum disease. Along with his team of dedicated professionals, Dr. Edwards’s experience allows him to assist patients in making informed decisions about their care, treatment options, and related procedure costs. Should you have any questions or concerns, please do not hesitate to e-mail us or call us at 317-842-2273.
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Reality 1: Dental insurance companies are interested in their profit above your health.
The team at Implant Dentistry and Periodontics works hard to ensure our patients have a great experience while feeling comfortable and relaxed. To assist with any insurance claims, our team will be happy to file the necessary paperwork if we receive your insurance information prior to your appointment. Please also update us of any changes to your insurance such as the insurance company, policy name, or employment change.
Reality 2: Dental Benefits are only meant to assist in receiving dental care.
Despite our commitment to maximize and aid patients with reimbursement through their dental insurance provider, it is ultimately the patient’s responsibility to understand the specifics of their policy as well as the differences between dental and medical insurance. A common misconception many patients share is that dental insurance covers 90-100% of dental fees. In reality, most insurance plans cover only 30-80% of the cost and in some cases, dental insurance reimbursements are lower than the actual costs incurred by the patient. This typically happens when the insurance carrier claims the doctor’s fees exceed what is considered reasonable, customary, or usual.
Each insurance company sets their own schedule and will differ on what fees they consider reasonable. This variation in reasonable fees occurs because each provider bases their fees from claims they process. Often, this data can be several years old, and fees are typically set to ensure the insurance provider nets a profit of 20-30%. In essence, this is the insurance company suggesting your dentist overcharged you instead of sticking to their responsibility to honor your claim. What insurance ultimately pays out will depend on the specific policy, how much coverage you or your employer pay for, and any contractual agreements between your employer and insurance company.
The primary goal of insurance companies is to make money. As such, the more they pay in claims, the less profitable they are. Because of this, it can be difficult to hold insurance companies accountable for a claim. A common tactic insurance companies employ to avoid or delay payment of a claim is to state information necessary to process the claim was not received. This grants them 45 days to delay paying the claim.
Reality 3: From time-to-time Dental Insurance will pay less to the policy holder than the actuals fees for the services rendered.
To benefit our patients, Implant Dentistry and Periodontics digitally documents the information sent to the insurance company and the date we sent it. Because insurance carriers are legally required to pay a claim within 30 days of receipt, we file most claims electronically to ensure it was received within a matter of days following treatment. Should the insurance company issue payment to us, we will audit the situation, and promptly remit the money to the insured.