Dental Insurance

Dental Insurance – Part I

“Coverage by contract whereby one party undertakes to indemnify or guarantee another against loss by a specified contingency or peril.” This is one of the definitions found on www.merriam-webster.com for the word “Insurance”. How does this apply to you and your dentist? Let’s break it down:

  1. Coverage by contract…”: The dental insurance policy is a contract, which is a legal document. As with any contract, it would be a good idea to read the whole thing before committing to it. Unfortunately, most all the contracts are negotiated between the insurance company and an employer, two parties with zero training in dentistry. So the contract doesn’t always contain language that has the patient’s (i.e. your) best interests in mind.
  2. … whereby one party undertakes to indemnify or guarantee another…”: “one party” is the insurance company, and the “another” is your employer. Notice that the dentist is not in there anywhere. As such, the dentist has no say in how the coverage is administered or formulated. Therefore, the only person/people with a voice that the dental insurance company must listen to is you and/or your employer.
  3. … against loss by a specified contingency or peril.”: This translates to mean, roughly, that the dental insurance company will financially “have your back” when you incur a dentally related expense. The confusion and/or frustration may begin when determining “how much of your back” they will cover. Typically it can be anywhere from 50 to 80% of the what the actual expenses are.

So, the basic meaning of dental insurance is that it is a contract between the insurance company and you in which they promise (for a premium) to help cover your dental expenses. It must be understood that the dentist has no rights or recourse in this contract. He or she can advocate for you, but you are the one that can legally argue with the dental insurance company.

Almost all the people in our practice that have dental insurance have acquired it through their employer. For some, it is included in what they pay monthly for their medical insurance. For others, it is a separate deduction in their paystub. The next entry will address the question “What do I get for my dental insurance premiums?”

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Choosing a Dentist…..What to look for

Take your time when choosing a dentist, but don’t wait for an emergency! A few ideas for where to look to find a dentist:

  • Ask family, friends, neighbors or co-workers for recommendations.  If someone you trust has had a good experience there, chances are you will too.
  • If you’re moving, your current dentist may be able to make a recommendation. They may still keep in touch with a dental school classmate, or a doctor they used to practice with.
  • Go online and find the local, regional, or state dental society.  There should be a listing of dentists there that you can look through.
  • Use your favorite online search engine. The dentist may have a website (or blog :-) ) that you’ll be able to read and find out about them.

So now you have a list of dentists.  How do you choose a dentist? Here are several things to consider, but it’s definitely not a comprehensive listing:

  1. Focus of the Dental Practice – Find out if the practice focuses on a specific type of dentistry.  For example, the dentist may focus exclusively on cosmetic dentistry, which may not be a very good option for someone with children.  Conversely, a dentist that specializes in treating children (called a Pedodontist) would not be a good choice for a retiree.  A general practice dentist should be able to do almost all facets of dentistry, with all types of patients.
  2. Location – Choosing a dentist close to home or work will make it easier to schedule visits and to arrive on time.
  3. Appointment Scheduling – Some offices may offer appointment times that are more convenient for you, e.g. after 5:00PM or on weekends.
  4. How about a visit? – You can do this either virtually or in person.  Check the dentist’s website to see if he has pictures of the office.  Also, read blogs to get a sense of what they are like.  The better option, of course, is to visit the office beforehand and get a feel for the place.  Is the staff courteous and friendly?  Is the waiting room and what you can see of the office clean, neat, and comfortable? While you’re there pick up any paperwork they’d like filled out and take it home to complete.  This way your first visit will be about meeting the doctor and staff, and not about getting forms done.
  5. “Age” of Practice – I don’t mean if the doctor has been practicing 5 years or 45 years.  I mean does the practice use a dark room to develop x-rays, or do they develop them on the computer?  Is there a computer in the operatory?  Does he/she use a laser in his/her practice?  Do they use intraoral cameras?  The technology in the practice you choose should be as good or better than the one you’re leaving.
  6. Paying for Treatment – What forms of payment will the office accept? Sure, cash and checks are a given, but which credit cards do they accept, if any.  Does the office have any financing options for large treatment plans?
  7. Insurance – Be sure you understand how the office handles this before your first appointment.  Ask if the office will send the claim in for you, and if they will have the payment sent to you or the doctor.  Is the doctor a “participating provider”, or are they just “accepting” your insurance?

In the end, the biggest determining factor in choosing a dentist will be how well you get along with the dentist.  Maybe he or she won’t have the most technologically advanced practice in town; perhaps they are not a participating provider of your insurance; the waiting room might not make the cover of Better Homes and Gardens; but when you are in their chair you will feel comfortable and at ease, and you may even laugh a little.  Then you will know you’ve made the right decision.

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Why am I writing a blog?

I’m still trying to figure this out myself.  I guess I just want to give my patients another avenue in which to connect with my practice.

The internet is the new reference medium.  I assume most people today don’t grab the Yellow Pages like they used to in order to find a dentist.  Instead, they Google or use Bing or Yahoo or something and get their information that way.  So, I thought I’d invest my time and effort into a place I know where people are looking for me.

My practice was built on word-of-mouth referrals.  Many, many people are talking to their friends via the internet (e.g. Facebook, Twitter, etc.), so this is a good way for me to be able to give them an opportunity to continue the referrals online (hopefully).

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I want to be…a…a…dentist!

OK – Here we go!  Welcome to C-K Family Dental’s first post!

Hopefully this blog will be like virtually visiting my office: it will be enlightening, low-stress, fun, and you’ll leave smiling!

Have a great day!

Dr. Theresa Casper-Klock

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