As a personal care dental practice, we provide the best possible care to our patients that we can. We can do this only by spending the time and energy needed by each and every patient and by using the best materials we feel are available.
1. Facts About Dental Insurance Your dental insurance is based on a contract between your employer and the insurance company. We are not a party to that contract. Should you have questions regarding your coverage, it is best to contact your employer, HR department, or insurance company directly.
2. Dental insurance differs dramatically from Medical insurance plans. 20-30 years ago the yearly benefits were similar to what they are today. Your premiums have increased but the benefits have not kept up with inflation. Therefore, dental insurance is never a pay-all, it is only an aid. Generally, we see benefits covering only emergency or basic care.
3. You may receive notification from your insurance company stating that dental fees are “higher than usual and customary.” The companies survey a geographic area , calculate an average fee, takes a percentage of that number and considers it customary. Included in this survey are discount clinics and managed care facilities, which bring down the average. The fee-for-service doctor in private practice will have fees that insurance companies define as higher than “usual or customary.”
4. Many plans will tell their participants that they will be covered “up to 80% or up to 100%,” but do not clearly specify their plan fee schedule allowances, annual maximums or limitations. It is more realistic to see coverage in the 35% to 50% range for major services. Remember the amount a plan pays is based on the amount of coverage the employer paid for. You only get back what you or your employer paid in minus the profits of the insurance company. We see differences within an insurance company for the same services. Obviously this is based on the plan purchased by the employer.
5. There are a number of procedures not covered under insurance plans and many procedures are recoded by insurance plans to a different service as determined by the insurance plan.
Financial arrangements must be made with us directly, regardless of insurance coverage. We will help you file a claim form with your company to help you receive your benefits.
Insurance Policies and Fees
Coming from a modest upbringing, Dr. Dersh understands how hard people work to be able to afford health care. With this in mind, we make it a point to keep fees as reasonable as possible, especially for the quality of service that we provide. Fees can be paid in cash, check, or credit card. We do not participate in any insurance plans, but will print out forms and submit them to assure your payment arrives to you as quickly as possible. Our non participation in insurance plans has to do with quality of care being determined by the patient and doctor rather than by an insurance plan. We will work with you to find an affordable solution that works for you, both financially and in terms of your desires for oral health.