The past 2 days our team has participated in the annual Utah Dental Association Meeting that is held at the Salt Palace, in downtown Salt Lake City. The convention has a space where vendors show their latest products and services and classes aimed at teaching new techniques, updating existing dental treatments, and things to consider to improve patient care and teamwork.Read More
Salt Lake City Dentist Blog
Every month you pay for dental insurance. If it comes out of your paycheck, you might not even notice...but you do pay for it.
There is a secret to getting the most from your dental coverage. Since we deal with insurance everyday, we know the secret and can share it with you: You are the boss. The insurance company works for you. You pay them to provide you a benefit. You are their customer. They have an agreement with you to reimburse you for dental expenses, and they have to answer to you for how well they do it. We work for you, too. You pay us to take care of your teeth. You are our customer and patient and we have to answer to you for how well we do. But we don't work for the insurance company, and they don't work for us, which means:
• We can't tell you exactly how much your insurance will pay (but because we see so many patients we can give you a pretty good estimate).
• We can't be sure how much of your benefit is left (but we can help you plan your dental work to minimize your costs).
• We can't tell you why your insurance company makes the decisions it does (but we can provide you with all the information you need to find out).
• We can’t be responsible for your insurance claim (but we can bill your insurance as a service to you).
Three things you can do to get the most from your insurance:
1.Talk to your insurance company. Before you come in, give your insurance company a call. Ask them how much benefit you have left, if there are any waiting periods, and how much your plan pays for preventative, basic, and major work.
2.Talk to us. We can schedule treatment to help you avoid going over your benefit. We can help you get a pre-determination letter showing what your insurance pays for treatment options. We can explain the costs and benefits of those options.
3.Ask questions. If something doesn't make sense to you, ask. You are the boss and are entitled to clear answers.
If you are covered by two dental plans…
When you are covered by two dental plans this is called "dual coverage." This does not "double" your coverage. However, it may reduce your out-of-pocket costs.
Dual coverage works the same way whether you are covered by two Dental insurance plans of the same company or by two different Dental insurance companies. Your primary dental insurance simply works with the other insurance company (secondary insurance) to coordinate your benefits.
Which plan pays first?
The plans set forth rules to determine which plan pays first, ("primary") and which plan pays afterwards ("secondary"). The general rule is that the plan that covers you as an enrollee is the primary plan and the plan which covers you as a dependent is the secondary plan.
For your children's coverage, generally the primary insurance company is determined by the birthday rule (i.e., coverage of the parent whose birthday —month and day, not year — comes first in the year is considered to be your children's primary coverage). A divorce agreement or other court ruling may supersede the birthday rule.
How dual coverage works
For example, if both of your plans provide two cleanings a year, each with 80 percent coverage, then: You would not be entitled to four cleanings a year. The primary plan pays its benefit as if there is no other insurance The secondary plan will act as a supplement to the primary plan with its payments limited to the lesser of its normal benefit or the patient’s out-of-pocket costs under the primary plan.
Non-duplication of benefits clause
Some dental benefit plans have "non-duplication of benefits" provisions. This means that the secondary plan will not pay any benefits if the primary plan paid the same or more than what the secondary plan allows for that dentist.
For example, if both the primary and secondary carrier pay for the service at 80 percent level but the primary allows $100 and the secondary carrier normally allows $80 for the same treatment, the secondary carrier would not make any additional payment. However, if the primary carrier only pays 50 percent of the dentist’s allowed fee, then the secondary carrier would reduce its payment by the amount paid by the primary plan and pay the difference. In this case, the secondary carrier would pay $14 ($80 x 80 percent - $50 = $14).
However, if the primary insurance plans annual maximum has exhausted all its benefits for the current policy year then the secondary insurance is obligated to pay at the rates outlined by the policy provisions of the secondary insurance plan.
Keep in mind that an insurance company will never guarantee that they will pay anything, even pre-authorizations are only determinations of benefits, no guarantee of payment.
Dual coverage saves money for you and your insurance by sharing the total cost of dental benefits between two carriers. Containing costs is an important part of your Dental insurance(s) plan to keep you smiling.
We're in the middle of our December rush. I don't mean getting ready for Christmas. Once again we have many patients that are trying to take advantage of their dental insurance benefits before the year ends. Most people who have dental insurance have a yearly maximum that is paid by their insurance company. Usually that amount is $1000-2000. If that amount is not used by the end of the year, those benefits are lost. Each October we send a postcard encouraging our patients with untreated dental disease to come in before the end of the year. Our hope is that they will come in October or November. Human nature being what is it is, most patients wait until December to seek dental care. Each year we are unable to accommodate all the requests for appointments.
This past weekend I had the wonderful opportunity to attend a continuing education course at the St. Regis Hotel in Deer Valley. What a beautiful resort. I didn't stay there (it's kind of expensive), but I enjoyed the amenities. The course was on replacing terminal dentitions with dental implants. A terminal dentition is one where the remaining teeth are in very poor condition and will not last much longer. Most times these patients suffer with pain and embarrassment and often end up with dentures. Dentures have been around for hundreds of years. They are not replacement teeth. Dentures are just an alternative to having and nothing. Many (as high as 50%) of denture-wearers do not wear their dentures. And when they do....
This fall we are starting a newsletter that will be mailed to many of our patients. The goal in providing this information is to make sure that are patients are well-informed about the services we offer and how dentistry can improve your general health and well-being. We plan to publish the newsletter each quarter and will make it available for free online to those interested parties. This quarter's dental newsletter can be found at this link: Dental Newsletter.
Award reflects company’s consistently high level of customer service
If you caught the programing on ABC’s “The View” on Friday you were largely misinformed. ABC aired a segment about jobs in our nation that don't require an education beyond high school. Dental Hygiene was one of them. This is false. Across the nation every state requires a two-year degree from an accredited university with a number of continuing education credits to obtain licensure.
It may be due to the economy, or in response to supply and demand, but lately there have been a lot of dentists advertising dental implants and what the fee is for those implants. In some respects, we'd hope you wouldn't shop for a dentist based solely on price, especially a surgical procedure, but I also operate with a budget and realize saving money is important and getting affordable dental implants is a worthwhile pursuit. So I'd thought I'd suggest a few things to look for and ask, when looking for a deal for dental implants.
This week is the Utah Dental Association's annual meeting. Most dentists and their teams will attend this 2 day event at the Salt Palace in Salt Lake City. I bring this up because a common question we get is how much CE or continuing education does a dentist need to take. In Utah, the requirement for continuing education is 30 hours every 2 years for both dentists and hygienists.
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