Insurance How it Works:
Whether you’re new to our practice or have been a valued patient for years, it’s important to be reminded how most dental insurance plans work. I would like to take this opportunity to explain why your insurance may not cover the entire cost of your dental procedure, or why it covers some dental procedures and not others. Most dental benefits plans are the result of a contract between an insurance company and your employer, union or association. The person who negotiates the terms of your insurance plan makes the final decision on maximum levels of reimbursement through a contact with the insurance company. Sometimes it may be noted on your bill that the fee I have charged you is higher than the reimbursement levels of UCR. It does not mean that our office is overcharging you – it could mean that the insurance company may not have taken into account up-to-date, regional date in determining a reimbursement level. Even though the cost of dental care has significantly increased over the years, the maximum levels of insurance reimbursement have typically not increased at the rate of inflation since the late 1960s. Other plans may want you to choose your dental care from a list of their preferred providers. Choosing your dental care provider from this defined group can affect your levels of reimbursement. Your plan may also tell you that they will only pay benefits for the least expensive alternative treatment for a condition, or deny coverage for conditions that existed before you enrolled in the plan. A deductible is the amount of dental expense for you are responsible for before your plan will assume any liability for payment of benefits and could increase your out-of-pocket expenses. In addition, many plan do not provide coverage for all dental procedures. This does not mean that these procedures are not necessary – it just means that your employer has purchased a plan that does not cover the cost of providing coverage for these services. Please discuss all treatment decisions with Dr. Caroline Berman. I hope this letter gives you a better idea of why your insurance may not pay 100 percent of your dental costs. If you have specific questions regarding your plan, or whether a specific procedure will be covered, contact your insurance provider or the human resources department of your employer to discuss the details. As always, thank you for being a valued patient. Washington Elite Dentistry: Dr. Caroline Berman, DMD is located in Washington, DC 20004. Our website has additional information about the following topics:
Dentist
Cosmetic Dentist
Family Dentist
Dental Implants
Dental Veneers
Emergency Dentist
Invisalign Dentist
General Dentist
Oral Surgeon
DC Dentist
Cerec Dentist
Washington Elite Dentistry: Dr. Caroline Berman, DMD is located in Washington, District of Columbia at:
555 12th St NW, Ste L300
Washington, District of Columbia 20004
Website: http://www.washingtonelitedentistry.com
38.8966929, -77.0276442
