Here at Gentle Dental Care we make every effort possible to provide you with the finest care and the most convenient financial options. To accomplish this we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures. We have provided a more detailed description of how this process works below. However, if you have any questions, please ask our staff. They desire to help you receive your benefits. We can be reached by phone at (231-723-3112).
If you have any questions or concerns regarding your initial visit, please call before you arrive.
Our Relationship and Commitment to our patient
A detailed look at how your dental benefits apply in our office.
At Gentle Dental Care, our highest value is the Patient-Doctor relationship. We are committed to providing you with the very best dental care available including information and guidance for you to make the best decisions for your health. This also includes helping you understand the benefits and limitations of your dental plan.
Most people are not aware of the vast difference between dental and medical insurance. Mainly, dental insurance is not insurance but a set-dollar amount benefit based on approved services. Most dental plans only allow for benefits based on a least expensive alternative treatment approach; the goal is to provide only basic care for specific dental services.
These specific services are predetermined by our employer when they contract with the insurance company. This means your three-way contract (you, your employer, and the insurance carrier) actually does not involve treatment options you and your dentist may find best meet your needs.
Within your contract there will also be limitations on the maximum amount available to you each year, as well as limitations on the frequency for normal procedures. For example, many plans have a $1,000 per year benefit and reimburse for two cleanings per year. As plans vary widely and it is impossible for a dental office to manage an insurance plan for each patient, it is in your best interest to know the specifics of your plan so you can make informed choices.
We understand how complex and difficult it is to work with dental insurance companies. That is why we provide assistance to you and are available to help explain dental plan issues to you. However, as levels of coverage and specifics vary plan to plan, we do ask that you be our own best advocate. We can help, but the responsibility and ownership of your plan is in your hands.
The following is an easy 3-step guide to help you receive timely reimbursements:
Step 1: Sharing Information
The most important step is to ensure proper information is provided to your dentist and insurance company including the following:
- Differentiate between your medical and dental card & coverage
- Provide dental billing address and phone number
- Provide the name and contact info for the primary insured person
- Provide correct identification numbers and birth-dates
- Provide other dental insurance (secondary insurance) before claims are submitted
- Who is providing the insurance e.g., employer, government, or intended provider
Step 2: Understanding Payment and Reimbursement
We are efficient at processing claims so that you get your insurance reimbursement in a timely manner after each procedure. Reimbursements for basic services are generally sent directly to you within one to two weeks, and for major treatment, within two to four weeks. If you notice a delay in receiving your reimbursement, please let us know, We will help you with follow-up and provide information as needed.
Step 3: When to Act
While we are able to assist you in most matters, there are times when a personal call from you to your insurance company or plan administrator will expedite their payment to you.
- If you enroll in Cobra
- If you claim has been rejected more than once
- If additional information is required
- If you have two dental plans in your name
- If you acquire your spouse’s plan
When any of the above cases occur we will generally need you to play a more active role to ensure you receive the maximum reimbursement from your plan. We will be with you every step of the way.
At Gentle Dental Care we are proud to be able to enhance the lives of our patients by providing personalized and high quality dental care in a comfortable setting. As part of your comfort, we will try our very best to ensure you get the most of your dental insurance benefits.