Why do I need a referral? Why can’t you do everything in your office?
We believe you deserve the best treatment available. That sometimes means referring you to a dental specialist that has the credentials and is specifically trained in that area, and that area alone. A general dentist providing these services may not be the best option for you. Just like your family doctor occasionally refers you to a medical specialist, our office will occasionally refer you to a dental specialist such as an oral surgeon, periodontist, prosthodontist, endodontist, orthodontist or pedodontist. Because you deserve the best treatment available. It’s what we would do for ourselves.
Why doesn’t my insurance cover the cost of my dental treatment?
Dental insurance is really a benefit provided by an employer to help employees pay for routine dental treatment. It is not really insurance (defined as payment to cover the cost of a loss). Employers usually buy dental plans based on the amount of the benefit and how much the premium costs per month. Most dental benefit plans are only designed tocover a portion of the total cost of treatment.
My plan says that my exams and certain other procedures are covered 100%
The 100% refers to what the insurance carrier allows (or what your employer choose for your plan coverage) as payment for the procedure, not what your dentist or any other dentist in your area may actually charge for the treatment.
Is my dentist charging more that he should? I received an Explanation of Benefits from my insurance company that states my dental bill exceeds the “usual and customary” fee.
Insurance carriers refer to their allowed payments as “usual, customary and reasonable” or UCR. UCR is a list of payments for treatment negotiated by your employer and the insurance company. The payment list is related to the cost of premiums and the geographic area where you live. In almost all cases, payments are usually less (and more often than not much less) than what any dentist in your area is actually charging for these dental procedures.
My insurance plan doesn’t go into effect until next month. Why won’t my dentist do my treatment today and send in the claim next month so my insurance will cover my treatment?
State and federal laws regulate these issues. It is insurance fraud to change the dates of service on a claim. Both patient and dentist can be prosecuted for doing this.
More questions? Give us a call at (970) 476-4898. We’ll be glad to help.
CareCredit® is here to help you pay for treatments and procedures your insurance doesn’t cover. We offer No Interest* financing or low minimum monthly payment options so you can get what you want, when you want it. You can even use CareCredit® for your family and favorite pet.