Patients have many misconceptions when it comes to dental insurance. I cannot address all of them but I am going to highlight a few of the most common things we see in our office. Don’t misunderstand and think that what I am going to say means I love to deal with insurance companies because no one likes to deal with insurance companies. Unfortunately, insurance companies are not going to go anywhere anytime soon so I just want to try and make the process not so painful.
1) You must know your insurance information. What I mean is that you have to provide the name of the insurance company, your ID number, the address and phone number for the insurance company, and the name of the employer who is providing the insurance. All of this information should be on your dental insurance card but if you are not provided a card you need to bring this information with you to your appointment. There is not a large database out there that tells us who you have your insurance through. If you do not give us the information then we have no idea what insurance company to send the claim. If you had one type of insurance and your company changed the policy you must provide the new information, your old insurance company does not have the new information nor do they care. When a medical office calls you and requests insurance information it is because we have been told by the insurance company that the information we have is not valid. If you do not return these calls in a timely manner your account can accrue interest that you are responsible for because you did not provide the correct information.
2) Don’t Listen to Your Friends! There are thousands of different insurance companies and there are hundreds of different policies for each type of insurance. Just because your neighbor has BB insurance does not mean that if you have BB insurance your policy covers the same procedures or at the same percentage. If you receive insurance through an employer then someone in the company has decided what procedures will be covered and at what percentages they will be covered. That means your neighbor may be able to have a crown and only pay 50% while your insurance covers 0%. If you have an individual policy than you chose what types of procedures were covered and at what percentages. We also see patients that work for the same company but choose different policies get upset that their coworker had better coverage. If you are given different levels of insurance to pick make sure you look at what is and is not covered before you sign up. There may be a significant difference in premiums but that also means there is most likely a significant difference in what is covered. Once you sign up for a particular policy you usually cannot change until re-enrollment comes around the following year.
As a dental office we feel your pain when it comes to dealing with insurance companies. The people in charge of insurance can spend hours trying to rectify one patient’s claim. We do understand that when you call an insurance company it can take a long time to find out the correct information. Please keep in mind that sometimes you, as the patient, are the only one who can contact the company to get that information. Our hands are tied by privacy notices and confidentiality practices but we do everything in our power to fix the issue before we contact you.