Three Mistakes People Make With Dental Insurance

Advice for dentists and patients on how to get the most out of insurance coverage.

Insurance can be a tricky beast. Anyone who has any kind of coverage knows that. Did the damage from that tree branch on your car do enough to cover the deductible? Maybe it did but “acts of god” aren’t covered by your insurance provider. Before you go in for surgery, do you know if your provider covers it or is it a non-essential work (according to your insurance company)?

Regardless, insurance is complicated, and big corporations are looking at one thing: the bottom line. If that means that they won’t cover you, even when they can, then they will do their best to avoid paying you what you are owed.

Let’s look at some common mistakes people make with their dental insurance — and how you can avoid them. These are mistakes made not only by insurance holders, but also by dentists’ offices when serving said individuals.

Not knowing the plan specifics

Often, dentists can make this one worse. Patients will often be given the specifics of what their dental insurance covers in long, readable form. Perhaps the dentist has already seen plans like this and chooses to inform the patient of what is or isn’t covered. Well, don’t take your dentist’s word as a de facto truth. The fact is, dentists often get it wrong, and when they do, they or the patients are held liable for the costs of the subsequent treatment if insurance won’t cover it.

Avoid the headache, and find out exactly what your insurance covers. This may be a difficult process involving lots of reading of legalese forms, or it may involve calling your provider and waiting on hold for extended periods. Either way, it’s better than getting stuck with a 500 or 1000 dollar bill because you and your dentist were certain insurance would cover it.

Confirm eligibility prior to treatment so you can avoid costly overpayments, on the dentist and patient side.

Knowing the plan specifics is important, but don’t let it decide your diagnosis or course of treatment!

Not submitting forms electronically

Simply put, it’s faster and cheaper. Your dental office may already have the set up in place to process paperwork manually, but then it has to physically be delivered to insurance companies. Do this stuff electronically so you can save time, money, and the headache of having to redo forms in the case that some bylaw or regulation changes.

As for patients, you should do as much as you can electronically as well. Why is this? Because it’s easier to make a paper trail. You can save screenshots of what your insurance promises to provide and what is actually on the documentation. You can also ensure you have electronic back-up copies of all important forms, bills, and payments.

Not separating financial agreements from the benefits assessment.

There was once time when dentists could simply treat patients and wait for their insurance to pay out. Nowadays, it’s not so simple. In modern practice, this wait time can have serious economic impact on the dentist’s office, if they wind up waiting for months or weeks for insurance companies to finally pay up.

The best way to avoid this is to ensure that the finances are secured and will absolutely be paid before treatment. Have the patient communicate with their insurance beforehand and the dental office can as well. Treating a patient and then finding out that payment for such treatments is only once yearly or once every six months can seriously hurt a small dental office.

Make sure you as a dentist know when and how you will be paid prior to treatment. Make sure as a patient you know when and how your insurance will handle your treatment.

Make a smile part of your day

Insurance is no doubt complex, full of loopholes, and frankly, a pain. But at Josey Lane, we can help you navigate its difficult rules. We are a private, family dentistry office that is happy to help you in any way, from dental check ups to surgeries to simply understanding your insurance. If you need treatment in the Carrollton Texas area, contact us today, and we will do everything we can for you.