1. ARE YOU IN MY INSURANCE NETWORK?
- Having been in the network of every dental insurance companies from 2008-2018, I found that being a contracted dentist to the insurance companies, the insurance companies became
our “boss”, not our patients. We trained to become dentists and dental specialists for additional 10-15 years so we can serve the patients, not the insurance. Insurance controls the our dental
profession from doing the best clinically for our patients by making us signed inches-thick contracts filled with tiny legal jargons, double meanings, sltealthily taking away our rights and
autonomy to be excerise our clinical expertise and the right to be fairly compensated for the necessary expenses such as the payroll and overhead, to name a few.
2.DO YOU TAKE MY INSURANCE?
- A dental office can accept dental insurance as a form of payment, such as food stamps in the grocery stores, even though the office may not be contracted
with a particular insurance.
- We do NOT accept State Medicaid and its affiliated plans, such as NJ Family Care.
- We do NOT accept Union Plans.
- We do NOT accept Delta Dental or any other major dental insurance plans because we want to make available QUALITY
dental care to everyone equally without sacrificing the quality of MATERIALS and quality TIME between patient and doctor.
3 .HOW MUCH IS MY TREATMENT?
- The cost for treatment is the same whether you are an independent self-pay patient or has a payment assistance plan through an insurance
- However, before the cost of the dental treatment procedure can be determined, a clinical dental exam, radiographic exam, your medical and dental health history are necessary.
Only with those information, along with digital photographs, I will be able to determine the diagnosis of the dental problem, and the type of treatment options your condition
- For those insurance payment assisted plans, We ALWAYS submit pretreatment estimate request to your insurance company prior to
beginning any dental treatment. Your company will send back what they INTEND to pay and your anticipated share of the
cost of your dental care. To help the everyone get a chance to get dental care that will at least keep their mouth healthy, I had created an in-House Discount Plan that is fair to you and me.
It does not dictate when or what treatment you can have, it does not have fine prints that negates the contract promises. It is not designed to get more patients to sign up. As I take my time
to thoroughly examine each patient and dental problem, I do not accept a large group of patients.
3. IS THE AMOUNT INSURANCE COMPANY PROMISED TO PAY RELIABLE?
- NO. Insurance companies are LEGALLY EXEMPT from paying their share at the last minute AFTER the dental care is provided. There are several limitations* that their lawyers wrote these exemptions
for the insurance companies in the contracts that you or your employer sign when you give them money to purchase an “insurance.” You always find out about this only when you use the benefit
plan you paid for.
* HERE ARE SOME OF THE COMMON LIMITATIONS...
1. WHY DO I HAVE TO PAY WHEN I HAVE DENTAL INSURANCE?
- Dental insurance is actually
not an insuirance, but a dental benefit plan. Also, it is only a form of financeial assistance to help with the expense of dental care.
- Some plans require that annual
deductibles is paid by you first to get the benefit of the dental insurance plan you bought.
- Dental benefit plans usually
pay 80%-100% of preventive care such as dental exams, dental x-rays, dental cleanings, and dental sealants. However, if you have a dental problem, such as a cavity or missing teeth, your plan
will only pay 50-80% of the cost. This is called the co-insurance or co-payment for the treatment procedures. The cost of treatment that is outstanding after your insurance company pays
is still your responsibility.
- Dental benefit plans usually
have limitations such as how often the insurance company will pay for common procedures, such as dental examination, dental x-rays, dental cleanings. Older dental benefit plans will pay
for only 2 exams, 2 x-rays, and 2 cleanings per year. It does not mean you only need 2 exams. There may be times where you need exams more than twice such as going to a specialist for a
consultation. However, if the insurance company sees that they already paid out for two exams, they will put the responsibility of the cost of the exam entirely on
2. WHAT IS THE DIFFERENCE BETWEEN A DISCOUNT
PLAN AND DENTAL INSURANCE OFFERED BY THE INSURANCE COMPANIES?
- DISCOUNT PLANS only came into
the market in 2013. This is the type of the plan was first created by insurance companies where they make you pay the insurance company to get a list of their contracted netowrk dentistists where you can get dental treatment for a “lower” fee. The subscriber pays for all dental
treatments, including dental exams and dental cleanings, to the insurance dentist at the time of the visit. For those treatments that are not negotiated by the insurance company with their contracted
dentists, you will be responsible for the dentist's full fee. With discount plans, insurance company does not pay anything toward your treatment as it would if it was a true dental insurance
- With the “true” “dental
insurance” benefit plan, there is a portion of money the insurance has to pay out each time you use your plan, because that was how the contracts begun decades ago as far back as 1950s. The insurance
collects money from you each month. In return, they give you a specific dollar figure they will pay out for your dental care expenses per year. Typically it started as $1,500 per year. About 60 years
later, this amount remained the same while the premium you pay to purchase increased. Living expenses and inflation increased. In addition, insurance companies found a way to legally decrease their
pay out by coming up with their own maximum reimbursement schedule regardless of what the true cost of dental care in the real world is where inflation, increased cost of living, etc.
3. I HAVE TWO DENTAL INSURANCES, DO I STILL
HAVE T0 PAY OUT-OF-POCKET?
- If you have two dental insurance,
it does not mean you have no out-of-pocket expense. On the contrary, you still have out-of-pocket expense 99.99% of the time after the secondary insurance pays out. There are times when
the secondary insurance will pay nothing out on your treatment but reduces your annual benefit with the secondary insurance by the amount the primary insurance paid