We are an out-of-network, private dental practice. This means that we are paid in full at the time of service. If you have dental insurance, we send the claim to your insurance company on your behalf, and any reimbursement they allow is sent directly to you, not to us.
We understand that dentistry can be expensive. To help you afford the dentistry that you need or want, we recommend payment plans through Care Credit and Lending Club. Both of these companies offer zero-interest and low-interest payment plans on approved credit.
Years of input from patients tell us that people don’t want to be pressured into treatment. We get it. In our office, we make every effort to act as your dental consultant first, to discuss the risks, benefits, and alternatives to all possible treatment options. Sometimes, doing no treatment at all is the best possible decision. In other cases, there are choices to be made with informed consent. We will help you choose the treatment that makes the most sense for you.
Insurance Predeterminations – Myths and Facts
Many of our valued patients use their personal or employer dental insurance as a way to limit or defray the costs of their dental health care. At our San Francisco Bay Area dentistry office, we want to do everything we can to help you understand your insurance coverage and to help you maximize your benefits, including understanding the ways dental insurance companies try to avoid paying for procedures.
One key aspect of dental insurance is the idea that patients get insurance preauthorization for procedures. Insurance companies often ask their clients to request preauthorization for treatments which dentists have already determined are necessary. Patients feel that preauthorization will help to reduce the risk of unexpected costs, but preauthorization is not required, nor does it reduce risk.
In our practice, we have often found preauthorization to be nothing more than an insurance company stall tactic. Insurance companies know that if treatment is delayed during the preauthorization process, there is a good chance it will not happen at all, as patients grow impatient and give up, or merely forget to follow up with their insurance companies. This can lead to the well-known risks of putting off treatment such as extractions, root canals, infections, and swelling. We now know that your dental health is directly related to your general health, so delaying treatment is not healthy.
It is important to remember that regardless of treatment or dentist, preauthorization does NOT guarantee payment. Whenever a preauthorization is completed, insurance companies make it clear that the final determination of benefits takes place only after treatment. If they deny authorization in advance, only the insurance company benefits.
Our San Francisco Bay area dentistry staff does not want our patients to be surprised or disappointed by the predetermination process. When treatment is recommended, there are often risks associated in waiting and predetermination does not guarantee payment. Our office and our patients have learned this from extensive experience in helping patients file their insurance claims. This is why our office does not recommend preauthorization or predetermination of insurance benefits. Your claim may be denied even with preauthorization.
We hope this information helps you to better understand your dental insurance. We are always happy to help you file your insurance claims and to help you maximize your benefits.