Insurance Questions

I will try to answer questions from my patients as they arise.  Today I want to answer one of the most common ones:  Why are you not “in network” with my insurance?

The answer goes back several years to the point when I had to make a decision: What type of dentistry did I want to provide to my patients?  Well, about 10 years ago I chose to provide only the type of dentistry to my patients that I would accept for my myself or my family.  It was not an easy decision.  Providing top quality dentistry comes with its own challenges.

First, you must have the skills and education to provide that type of dentistry.

Second, insurance companies are in the business to “not” provide dental benefits.  If every insurance company paid for dentistry on their members then they would be broke (or are they already – AIG?).  Seriously though, insurance companies try to pay as little for as little as possible.

So, 10 years ago I became an “out of network” provider for all insurance companies for the benefit of my patients.  It was a tough move at first, but my practice grew tremendously because I focused on my patients and their needs instead of what the insurance would cover.  Over the past 10 years I have been following my patients and am now able to point out a few tremendous benefits of top quality dentistry:

1. LESS Emergencies – Yes, I have nearly zero emergencies with my patients!  A thorough new patient exam coupled with a complete exam annually virtually eliminated emergencies for my existing patients!  What a great benefit.  All my patients know exactly where they stand with their oral health.  Everything is outlined after their consultation.  There are no surprises.
2. LESS Root Canal Treatments – Yes, I do very few root canal treatments on exiting patients!  Root canal treatments are due to accidents, severe decay or poor dentistry.  Accidents are accidents and will happen.  Severe decay should never happen as a dentist needs to find the initial warning signs way before it gets that bad.  And poor dentistry, well, that we just don’t have here.  That being said, I think it is very sad to see holes in crowns (caps) that were placed by other dentists.  This usually means the cap was cemented and required a root canal treatment afterwards.  I can’t remember the last time I had to do a root canal on a tooth after cementing the final crown.
3.  LESS Dentistry– The best benefit of all, top quality dentistry and meticulous exams result in less dentistry over the patient’s lifetime.  I address dental problems when they just begin to appear, hopefully preventing the need for more invasive dentistry down the line.  Quality dentistry lasts longer, fits better and functions correctly.  This is not as common as you might think.  These factor together result in less visits to the dentist, less redoes, less pain.  You actually will save money in the long run by choosing top quality dentistry!  Not to mention the increased comfort, better function and beautiful aesthetics.

The difference between exceptional dentistry and average dentistry, financially, at first, is not as much as you might think.  Most insurance companies will pay towards dental treatment even if you are out of network.  Even if you are in network, they might reduce your benefit to something smaller and make you fight for your money.  It is a game they play.  With a practice like mine we exclusively focus on you and your needs.  As a benefit to you we will file your insurance information and fight to get you your benefits, but we will never have a dental insurance company tell us what we can and can’t do for you! 

The ONLY reason I am not in network with insurance companies is to be able to provide quality care for my patients.  Period.

I hope this helps.  Most of the patients in my practice understand this answer perfectly and would not go anywhere else regardless of insurance.  I invite you to stop by and see the difference for yourself!