We accept many dental insurance plans and will file claims on your behalf, saving you the time and hassle. Our knowledgeable benefit coordinators can help you maximize your dental benefits and minimize your out-of-pocket cost. We will tell you upfront what your insurance plan will pay for and offer options for taking care of any remaining balance. Below you will find the differences between insurance plans; our office can accept any PPO Dental plan, but we do not accept HMO or discount insurance plans.
What’s the difference between indemnity, PPO, HMO, & discount insurance plans?
Indemnity or Traditional Insurance reimburses members or dentists at the dentist’s UCR (Usual, Customary & Reasonable fee). This allows the subscriber to go to any dental office without being limited to a panel.
Also known as capitated or prepaid insurance, was designed to provide members with basic care at the lowest rate. Participating providers receive a monthly capitation check for patients assigned to the office. This amount is only a few dollars and is intended to offset the administrative costs. HMOs generally don’t pay for services rendered. Fees are usually greatly reduced, but the patient is solely responsible for paying the doctor.
PPO (Preferred Provider Organization)
Is the most common form of insurance. They provide members with a list of participating dentists to choose from. The dentists on this list have agreed to a lower fee schedule, which provides you with greater cost savings. They also assist with insurance billing. Most companies pay 50% on major treatment (crowns, bridges, partials), 80% for basic care (fillings), and up to 100% for preventative care (exams, x-rays, basic cleanings). Annual maximums generally range from $1,000 to $2,000.