Regarding Your Dental Insurance
Your dental insurance coverage is a benefit usually provided by an employer. This means that the employer decides what treatment is to be covered by the policy and what is not. The insurance then honors the parameters of the policy.
As is the case with most insurance policies, some items are hidden within the “fine print”. Berkeley Heights Dental Group promises to investigate the details of your policy and try to navigate you through the complicated world of insurance. However, sometimes there are certain clauses withheld from us that are not discovered until after a claim has been submitted. When these situations occur, we will deal with the insurance companies on your behalf until all avenues on our end have been exhausted. On rare occasions, the policy holder may be asked to contact the insurance company or the provider’s human resources department to deal with unreasonable circumstances. Ultimately, all accounts are the patient’s responsibility as well as to know and understand their dental insurance policy. Some areas of confusion include:
- The number of examinations and dental cleanings allowed within a calendar year.
- The timing of dental cleanings; is coverage allowed anytime during a calendar year or are they allowed 6 months + 1 day to the date of the previous one.
- Teeth missing prior to the initiation of current coverage may not be able to be replaced with a new policy (missing tooth clause).
- Crown and bridge replacement, occlusal guards, and alternative benefit clauses (which includes amalgam filling coverage for “white fillings”)
If you have any questions regarding your policy, please ask us or contact the provider of the policy. If your coverage changes at any time, please contact our office immediately with the new information so we may provide you with best possible service.