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Dental Insurance Insufficiency Program™
Our commitment to your health and that of your teeth and gums involves the care, skill and judgement that we bring to you in providing minimally-invasive, maximally-predictable therapies. As you bring your hopes, time, effort and motivation to our practice, we also know how important is the issue of the treatment costs, and where applicable, how dental insurance may help you obtain the necessary treatments. Over the last 27 years, our commitment to our patients is to not only provide the most advanced therapies, but also to provide them in a cost-containment environment. While over the last 10 years, our average yearly cost increase has been below 2% (compounded yearly), we have unfortunately seen that dental insurance reimbursement has seriously declined over the last 5-7 years. This unfortunately has meant that patients have been forced to pay more out of their own pockets than they would have paid for the same treatements provided to them even just 5 years ago.

The Problem
Dental insurance companies have increased the tendency to limit their coverage on a yearly basis. This "yearly maximum" is not a problem and frequently involves a yearly limit of usually $1,000 or $1,500. This is not uncommon and is a good way to keep their premiums down, and therefore affordable for many people. The problem that we see is what relates to insurance companies reducing their reimbursements for specific procedures. "Usual and Customary Fees", "Prevailing Fees" or "Scheduled Allowances" all mean different things to different companies and even may cause for variations in reimbursements by the same company. Unfortunately for patients, this may mean huge variations in their "out-of -pocket" expenses. An example of this patient problem is as follows (this case is on file for your viewing) and involves this husband and wife:
Procedure
Insurance Company
 Reimbursement
Mrs. S. D. rootplaning
MetLife
$400.00
Mr. S. D. rootplaning
Aetna
$200.00
MetLife described their $400.00 reimbursement as "the amount allowable under the dental benefit plan". Aetna described their $200.00 reimbursement as "within the prevailing range of fees charged in the area".
--- while MetLife's reimbursement is below the normal fee for that procedure, the fact that they pay twice as much as Aetna for the same procedure means that Aetna will have $200.00 more for profit that the patient
will have to pay for out of his or her own pocket. The patient is subsidizing this profit!

The Solution
Our primary responsibility is to get you healthy regardless of the level of insurance coverage you may or may not have. We would like to help you reduce your financial concerns. We know that we usually treat adults who have always put their childrens' needs before their own. Therefore, we have created in this office the Dental Insurance Insufficiency Program as a means to help you get the periodontal therapy that you need. This program can work for you in two ways which are:

A. Spreading Treatment over Two Insurance Years (If you have a yearly maximum)
In most cases, we are able to spread treatment over two different insurance years without compromising your health. If this isn't the case, you will be advised accordingly. However, where we can do enhanced non-surgical treatments for gum disease (periodontitis), the healing that we obtain allows us to control the disease to the point that your surgical needs can be spread over two different years. If multiple gum grafts are needed, their scheduling can be done over two years.

B. Spreading Your Payments over a Longer Time Period
We would always prefer to have payment completed at the time that our treatments are finished. However, if you need to spread payment over a longer time period, that is something that we are glad to arrange for you. This is routinely done! My concern is that you are healthy! We do not want the need for longer payment arrangements to complicate your need for periodontal therapy.Don't hesitate to tell us how we may be able to help you get healthy while reducing your concerns over your financial commitment.

Insurance Pre-determinations.
My staff is here to help you understand how we can better serve you. We will be glad to send in your insurance for a "pre-determination of benefits" before you initiate treatment. Once the insurance company states in writing the limits of your plan , we can then arrange a schedule for you to pay only on what your share of the treatment costs are.

We look forward to being able to serve you!