Years ago I was a participating dentist with a dental insurance. I was young and thought this was a good way to build my practice with the help of a dental insurance company. By agreeing to participate, I agreed to take a cut in what I was paid for a procedure. I thought every dentist participated, so I better join them.
Then one day I did a case on a patient. I placed eight beautiful porcelain crowns in the front of her mouth. What we call the “esthetic zone”. She worked for a school district at the time and had good insurance coverage, according to the patient. Once all was done, the insurance paid for the procedure. I ended up making pennies on the procedure. I called the insurance company because I thought there was a mistake. I wrote a letter explaining my fees, lab fees, cost to run the office etc. I finally talked with a supervisor and she told me two things: one- I needed to use cheaper labs and two- I spent too much time with my patients! I then sat down and wrote another letter to stop my participation with the insurance company. I thought how could an insurance company tell me how to run my office? I was in “private” practice. I wouldn’t use a cheap lab or cheap product on my family members, why would I use cheaper products on my patients?
I view dental insurance as a coupon. Just like a Macy’s coupon has exclusions, so does insurance. Dental insurance is not truly insurance. Look at your home-owners insurance. If a storm should happen to come through the neighborhood and tear the roof off your house, you would call your insurance company. They may have you get an estimate or two or send and adjuster out to assess the damages. Soon you will then have a new roof fixed in full. Payment would be paid minus your deductible. Now you break a tooth eating chicken. You go to your dentist and find out you need a crown. Your insurance company will ask for an x-ray, a pre-determination that may take weeks to get back. Then you find out that they will not pay in full for the crown. They may only pay for half of it or maybe none of it. You may not have crown coverage. That might be your exclusion. Forget anything cosmetic like veneers or whitner, that’s right, another exclusion. And there are time limitations. Meaning if you had a tooth fixed and something happen to it within a certain time period, they won’t cover it again.
At our office we will submit ALL insurances. The insurance company will reimburse you. Since the contract is between you and the insurance company, the relationship is also between you and the insurance company. The patient and doctor relationship is totally different. We treat you not the insurance. We build a relationship with you and trust with you. Our personalized dental plans are only for you. We make it all about patient/doctor-office relationship, if we threw the dental insurance company in that would make three. And we all know three’s a crowd!
If you are looking for individualized dental care, please call our office for a consultation and evaluation.