Justin Settle DMD

Facts About Dental Insurance

Dental insurance is a contract between your employer and insurance company to partially pay for some services.  It exists to help cover the costs; it was never intended to cover all costs.  There are deductibles and some services that are paid at 50 to 80% and some that aren't covered at all.  The type of coverage depends on how much your employer is willing to pay for it.  The higher the premium paid by the employer, the better your coverage.  Many dental services are covered a specific number of times in a year (for example, cleaning appointments may be covered only once every six months.)

Will you bill my insurance?

We will help you maximize your insurance benefits and as a courtesy, we will fill out your claim forms and bill the primary insurance company.  We do require that you pay your patient portion at the time of service.  As stated above, once your insurance pays, any amounts that are not covered are your responsibility.

Do you accept my insurance?  How much will my insurance pay?

We accept most insurance plans that don't require you to select a dentist from a list (managed care dentist)

Each insurance company sets their own arbitrary fee for each dental procedure based on the dental offices' zip code.  They call these fees "usual and customary".  The insurance companies establish artifically low fees in an effort to avoid paying out.  Some insurance companies tell their clietns that "fees are above the usual and customary", rather than saying their their  "benefits are too low".  Most insurance companies haven't changed their pay out fees since the 1970s.  In our office we don't view our patients as "usual and customary", but as quailty people who we expect quality dentistry.

As we recieve payments from dental insurance, we save the payment information to assist us in quoting future patient portions.  However, in some cases the insurance companies withhold their payment information from the dental offices.  Thus, sometimes it is impossible for us to give you an exact quote on what they will reimburse.  We can only estimate your patient portion based on the most up-to-date information we have.

Will you join my insurance?

Every dentist is solicited numerous times a year to join managed care plans.  The only requirement to join is that the doctor agrees to reduce their fees by 40 to 60%.  In order to make up for lost revenues, the office (or corporation they serve) must cut corners.  This can be done by cramming more patients into their schedule; or using the cheapest materials, laboratories or even sterilization procedures.  Any way you look at it the patient is the net loser.

Sacrificing quality, service and personal attention is not exceptional customer service.  Interestingly, we have found that office which are enrolled in these programs either have difficulty retaining their doctors and staff or the office only stays in the program for a short while.

How much do you charge?

Our fees are set by the actual cost of doing business.  We take into consideration the quality of materials used, the laboratory costs, the quality of our team members and many other factors.  The truth is you would be surprised at the lengths we go to in order to keep costs down while maintaining a high level of service.  We have never tried to be a dental office for everyone.  We have never tried to be the cheapest because there is standard of quality we will not go below.  You never save money buying cheaper materials because they don't last as long and the patient ends up returning in a few years because the crown has failed.

Please do not hesitate to ask any queations about our office policies.  We want you to be comfortable in dealing with these matters and we urge you to consult us if you have any questions regarding our services and/or fees.  As a courtesy, we will fill out and file insurance forms for you at no charge.  We will do all we can to assure you of maximum benefits, but bear in mind that the insurance company is responsible to you and you are responsible to us for your account.  We cannot render service on the assumption that the charges will be paid by the insurance company.  Thank you for understanding.