Dental Health vs Dental Insurance
Did your dental insurance deny payment?
Many people have dental insurance or an allowance to supplement the cost of dental treatment. Sometimes after treatment the patient will receive an explanation of benefits from the insurance carrier stating they won’t pay for the procedure.
Upset with your dental bill?
Now you’re mad at that bleep, bleep dental office.
Did your dentist do something you didn’t need?
Why didn’t the receptionist known they wouldn’t cover that procedure?
How can you prevent this from happening?
Here is an examination of the different groups involved.
Get the facts before the work is completed.
The insurance company and the company purchasing the insurance, have essentially the same goals, which is to provide you with a plan that doesn’t cost them much, has lower reimbursement, limited coverage, high deductible, and high premiums.
The patient and the doctor have the same objectives; good complete care, reasonable fees, and the ability to choose the type and extent of treatment, and coverage for that treatment.
These are contradictory goals.
The company purchasing the policy is looking to spend as little as possible. So they buy a policy that doesn’t cover the newest, best, longest lasting treatments. The insurance company wants to maximize its profits. They write confusing, continually changing, benefit packages that only cover the cheapest alternative. They don’t allow anyone to see the details of the plan. And, if those hurdles aren’t enough, they will employ a “consultant” to deny treatment.
The patient wants the best, stress-free, painless dental care that doesn’t cost them any out of pocket expenses. The Oral Surgeon wants to perform procedures that will eliminate any current problems and potential problems, and restore the mouth and jaws to their original shape and form, both for function and aesthetics. The doctor should be, and wants to be paid enough to provide a comfortable environment, qualified staff, and make a profit.
It’s interesting to note that the set of objectives of the patient and the dentist are the closest. That’s one of the reasons they should be choosing the treatment together during a consultation appointment. Not allowing a third party to dictate the cheapest alternative.
Does that mean the patient won’t have to pay something out pocket?
No!!
But that possibility should be discussed before treatment is started.
