Frequently our patients ask us what their insurance will cover and, “Why doesn’t my insurance pay for this?” The following explanation was provided by the American Dental Association in 2009. We hope that it answers your questions.
Under a UCR plan, patients are usually allowed to see the dentist of their choice. These plans pay an established percentage of the dentist’s fee or pay the plan sponsor’s “customary” or “reasonable” fee limit, whichever is less. Although these limits are called “customary,” they may or may not reflect the fees that area dentists charge.
It may also be noted on your bill the fee that your dentist has charged you is higher than the reimbursement levels of UCR. This does not mean your dentist is overcharging you. For example, the insurance company may not have taken into account up-to-date regional data in determining a reimbursement level.
Why? There is no regulation on how insurance companies determine reimbursement levels, resulting in wide fluctuation. In addition, insurance companies are not required to disclose how they determine these levels. The language used in this process may be inconsistent among carriers and difficult to understand.
Your plan purchaser makes the final decision on “maximum levels” of reimbursement through the contract with the insurance company. Even though the cost of dental care has significantly increased over the years, the maximum levels of insurance reimbursements have remained the same since the late 1960s. Many plans offer higher maximums that are comparable to rising dental care costs.
Your plan may want you to choose your dental care from a list of their preferred providers. Whether or not you choose your dental care from this defined group can affect your levels of reimbursement.
Your dental plan may only allow benefits for the least expensive treatment for a condition. For example, your dentist may recommend a crown, but your insurance may only offer reimbursement for a large filling. As with other choices in life – such as purchasing medical or automobile insurance or buying a home – the least expensive alternative is not always the best option.
Just like your medical insurance, your dental plan may not cover conditions that existed before you enrolled in the plan. Even though your plan may not cover certain conditions, treatment may still be necessary.
Your dental plan may not cover certain procedures or preventative treatments such as sealants that can save you money later. This does not mean these treatments are unnecessary. Dr. Han can help you decide what type of treatment is best for you.
The process of receiving dental implants can take several months, as each stage of the process requires time for healing and proper placement. Our team will provide you with a detailed timeline during your consultation.
Dental implants are designed to mimic the look and feel of natural teeth, providing improved speech and chewing ability compared to missing teeth.
The cost of dental implants can vary depending on several factors, such as the number of implants required, the type of implant, and the location of the practice. Our team will provide you with a personalized quote based on your specific needs and goals.
The process of receiving dental implants is minimally invasive and done under local or general anesthesia to ensure your comfort.
Dental implants can last for many years, sometimes even a lifetime, with proper care and maintenance.
You should care for your veneers just like you would care for your natural teeth. Brush and floss regularly, and avoid biting on hard objects or chewing ice.
Veneers are a non-invasive procedure and typically do not cause pain. However, you may experience some sensitivity after the procedure. Our team will work with you to ensure your comfort throughout the entire process.
Yes, veneers are designed to look natural and blend in with your existing teeth. We use only the highest quality materials and techniques to ensure a seamless and natural appearance.
Veneers typically last between 10-15 years with proper care and maintenance.
Veneers are placed in two appointments. During your first appointment, we will prepare your teeth and take impressions of your teeth to be sent to the lab. At your second appointment, we will bond the veneers to your teeth, ensuring a perfect fit and natural appearance.
Teeth whitening is generally considered to be a cosmetic procedure and is not covered by insurance. However, we offer affordable payment and financing options to help you get the smile you deserve.
It's best to wait for a minimum of 6 months between teeth whitening procedures to avoid damaging your teeth or gums. However, the frequency of teeth whitening will depend on your individual circumstances and the extent of the discoloration.
We recommend avoiding food and drinks that can stain your teeth for the first 24 hours after the procedure. After that, you can eat and drink as normal, but it's best to avoid foods and drinks that can stain your teeth.
Our chairside teeth whitening procedure typically takes about an hour, depending on the extent of the discoloration and the desired results.
Yes, teeth whitening is a safe and effective way to improve the appearance of your smile. Our Opalescence teeth whitening system is specially designed to be gentle on your teeth and gums.
Our experienced team at VIP Dentistry can diagnose and treat TMJ disorder using the latest technology and techniques. We offer personalized treatment options and will work with you to determine the best course of action to help you achieve a healthy, pain-free jaw.
Treatment options for TMJ disorder may include custom-made splints and night guards, orthodontic treatment, physical therapy and exercises, joint injections, or surgical treatment for severe cases.
TMJ disorder is diagnosed through a thorough evaluation by a dentist or oral and maxillofacial specialist. This evaluation may include reviewing your medical and dental history, a physical examination, and imaging studies, such as X-rays or MRI.
The symptoms of TMJ disorder may include jaw pain, headaches, ringing in the ears, neck pain, and difficulty opening and closing your mouth.
In some cases going to the ER can be an acceptable course of action if you are experiencing a dental emergency. For example, if you are having trouble breathing due to swelling around your jaw then it is advisable that you go straight away for medical attention. However, if your issue is more related to pain or discomfort in your mouth then it would be better for you to visit a dentist right away so that they can provide more specialized care.
Yes, it is important to see a dentist as soon as possible during a dental emergency. While some situations may not be serious enough to require an immediate visit to the ER, if you are experiencing pain or discomfort in your mouth then it's best to see a dentist for an accurate diagnosis and treatment plan. A dentist will be able to assess the issue and determine how best to address it in order to alleviate your pain and restore your oral health.
Yes – conscious sedation dentistry options are available here at VIP Dentistry, so patients who feel anxious about undergoing certain treatments no longer have anything worry about; this type of sedation reaches an optimal level of comfort while delivering effective results allowing us to guarantee delivery of quality service regardless complexity presented.
Some of the most common dental emergencies can be prevented by taking a few simple precautions. Avoid chewing hard foods, such as candy and ice, as these can cause your tooth to crack or chip. Also, be sure to wear a properly fitted dental mouth guard during sports and other high-impact activities. Protecting your mouth on a daily basis can significantly reduce your risk of injuring your teeth, as well as your tongue, lips, and the walls of your mouth.
Urgent problems that threaten the health of your teeth or leave you in pain should not be ignored. You can expect to be seen by your emergency dentist quickly and without an appointment though it is recommended that you call your dentist’s office, if possible, before you arrive.