Insurance
Dental insurance is unlike medical insurance in that in dentistry it is a co-pay system where you are expected to participate in your dental health care expenses. They have no intention of paying all of it. It is something people pay for to HELP with expenses. Dental insurance companies expect you to: 1) pay your premiums, 2) pay a deductible amount each year before they participate, 3) pay for none, part or all of some services, and, 4) set a yearly limit to reduce their losses. We are not a “provider”, or employee, of any insurance company. Some insurance companies want dentists to provide sub-standard care to increase their profits from your premiums. We do work with all insurance companies, and will submit claims and explanations on your behalf, for your benefit. However, they sometimes will not respond to us or pay and need to be contacted by you, the policy owner, since you are paying them to help with your care. They only pay a percentage of their predetermined fee schedule based on the rate of premiums they receive from you. Each patient is responsible to pay for anything not paid by their insurance company. “Usual and Customary” is a term they use referring to what they “usually and customarily” pay based on your policy, and is not based on the actual fees charged.