Maximizing Your Dental Insurance


By Ida Katz, Office Manager, Tuesday June 5, 2007

For over twenty years, I have helped patients understand their dental insurance benefits.  Although many patients come to our practice confused as to the extent of their dental coverage, we help, by contacting their insurer to determine the type of coverage they have.  Often dental insurance companies will fax us an out line of the patient’s coverage, including yearly maximum coverage, the types of procedure covered and the percentage of co-pay for each type of procedure.  The insurers usually include what procedures are excluded from coverage. 

 After Dr Spindel performs an examination and determines a treatment plan, I usually send it in to the insurance company for a predetermination.  In two to four weeks the insurance company will return a response, which details how much the insurance company will pay for the proposed treatment and what the patient’s co-pay will be for the proposed plan.

 At this point, if the patient desires, they can start treatment and be assured how much of the cost will be paid by their insurance. Although predetermination is not required prior to treatment, many patients  feel better having their treatment preapproved.

 Some patients require treatments which exceed their yearly insurance maximum.  If the patient can’t afford their entire treatment plan, Dr Spindel is consulted and we (the patient, Dr Spindel and I) determine which treatments are most important.  The treatment can be done in stages . If finances are limited this often allows patients to maximize their insurance benefits and patients can both get the care they need and afford.