Insurance Questions
Insurance can be confusing. Here are commonly asked questions about insurance.
What dental insurance do you file in your office?
AARP
AARP Dental Insurance Plan
Advantica Benefits
Aetna
AFLAC- GA
Allegiance Benefit Plan Management
Ameritas Life
Anchor Benefit Consulting Inc
Argus Dental Plan Inc
Assurant Employee Benefits
Assurant Health
Assurant Supplemental Ins
Avesis
BCBS of Alabama
Best Life & Health Insurance Co.
Blue Cross Blue Shield Anthem Complete
Blue Cross Blue Shield Federal Employee Program
Blue Cross Blue Shield FL (Florida Combined Life)
Blue Cross Blue Shield of Florida
Blue Cross Blue Shield of Georgia
Blue Cross Blue Shield of Illinois
Blue Cross Blue Shield of Indiana (Anthem)
Blue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of Michigan
Blue Cross Blue Shield of South Carolina
Blue Shield of California
CareFirst Inc. Maryland BCBS- FEP
Carpenters Health & Welfare
Chesapeake Life Ins. -Careington Benefit Solutions
Christian Brothers Services
Cigna Dental Health PPO
Cypress Benefit Administrators
DDIC (AL, AK, FL, GA, LA, MS, MT, NV, TX, UT)
Delta Dental Northeast (ME, NH, VT)
Delta Dental of Arkansas
Delta Dental of California
Delta Dental of Colorado
Delta Dental of Illinois
Delta Dental of Illinois Group Plans
Delta Dental of Iowa
Delta Dental of Kentucky
Delta Dental of Massachusetts
Delta Dental of Michigan
Delta Dental of Minnesota
Delta Dental of Missouri
Delta Dental of New Jersey
Delta Dental of New York
Delta Dental of North Carolina
Delta Dental of Ohio
Delta Dental of Oklahoma
Delta Dental of Pennsylvania
Delta Dental of Rhode Island
Delta Dental of Tennessee
Delta Dental of Virginia
Delta Dental of Virginia
Delta Dental of Washington State
Delta Dental of Wisconsin
Delta Dental Plan of California – Tricare Retiree
FEP Blue Dental
Florida Blue FEP
Freedom Life
GEHA
Government Employee Hospital Association (GEHA)
Guardian Life Insurance Co. of America
Healthplex Inc.
Horizon BCBS NJ FEP
Humana
Humana Specialty
Lincoln Financial Group
Maxor Administrative Services
Medicare
Meritain Health Minneapolis
MetLife
Missionaries Of Africa
Mutual of Omaha
Mutual of Omaha Commercial
National General
Physicians Mutual
Plumbers and Pipefitters Local 123
Principal Financial Group
Renaissance Life and Health
Renaissance Life and Health
Rural Carrier Benefit Plan
Solstice Benefits Inc.
Sun Life Financial
Teamcare
TeamCare Central States Health Plan
United Concordia
United Health Care (UHC)
United of Omaha
Don't see your insurance company on the list?
Please call our office and one of our friendly staff members will call your insurance company and get your benefits sent over. Our number is 727-327-7701.
What is a PPO or DPPO dental insurance plan?
This stands for Preferred Provider Organization or Dental Preferred Provider Organization. Most dentists charge UCR (Usual, Customary and Reasonable) fees set forth by the American Dental Association. These fees are fairly charged to the patient and reasonably compensate the dentist based on overhead (zip code?). This allows the dentist you are seeing to use quality products and spend the time needed to perform dental procedures properly, providing the best treatment possible. Most PPO plans allow you to select the dentist of your choice and have the same benefits in-network as they do out-of-network. Most dentists will work with PPO or DPPO plans and not HMO Plans.
Does your office file PPO or DPPO dental insurance? Section
Yes we do! We call your insurance company, obtain a breakdown of benefits and file your insurance claims for you. See the list of insurance companies below.
What is an HMO dental insurance plan and do you accept these plans? What is the difference between HMO and PPO dental plans? The information below is worth reading.
HMO or DHMO stands for Dental Health Maintenance Organization or Health Maintenance Organization. If you have an HMO plan you have probably exhausted yourself calling offices to see if they accept it. HMO plans compensate dental offices very little on procedures therefore most dentists do not accept it, this leaves you with a limited list of providers to choose from. Dentists who accept HMO plans see double, if not triple the patients a PPO dentist does in a given day. For example an HMO dentist would typically receive around $25, from the insurance company, for their hygienist to clean a patient’s teeth. A patient should have an entire hour reserved for their cleaning appointment. This being said $25 would not cover the hygienist salary, materials used and other overhead required to see this patient, therefore an HMO dentist will see two-three patients in an hour to be able to afford keep their office open and running. This applies to fillings, crowns and other dental work as well. This type of rushed treatment typically results in poor workmanship due to an overworked dentist and staff, which later leads to unnecessary and expensive dental treatment in the future. HMO plans will not pay offices out of network and they will not reimburse you. We do not accept HMO insurance for this reason. We always spend the time necessary to properly treat patients and make sure every procedure is meticulously performed.
Can I switch my HMO to a PPO/DPPO plan?
Yes and you will need to call your HR or insurance company to make the switch. You will likely pay more for a PPO plan but remember you get what you pay for. If you don’t need a lot of dental treatment you may want to consider not purchasing a plan altogether. You might end up paying more than you will receive in benefits. Insurance companies only pay for a percentage of most dental procedures. When you call your insurance company to switch plans, you may want to ask the following: 1) Can I can go to the dentist of my choice? 2) Does my plan pay out Usual, Customary and Reasonable fees and NOT a fee schedule? If they pay on a fee schedule you will be responsible for the difference of the dental procedure and insurance payment. 3) Does the insurance company pay the dental office? This is called ‘Assignment of Benefits’. If the check is paid to the patient, the patient or policy holder will need to pay for the procedure in full and the insurance company will reimburse you the percentage covered weeks or months later. Not all PPO plans are worth paying for and can be just as bad as HMO plans. Call or come in our office and we are happy to answer insurance questions at no charge. We are here to help!
What does insurance typically pay on cleanings, x-rays, exams, fillings, crowns, bridges, extractions and dentures?
It depends on the insurance plan you have. Most insurance companies pay cleanings, x-rays and exams (preventative procedures) at 100%. Fillings (basic procedures) are typically covered at 80% and crowns, extractions, bridges, dentures (major procedures) are typically paid at 50%. After your first visit and upon your request, we contact the insurance company to obtain a pre-determination from your insurance company on exact cost.