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Dental Insurance Facts
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Dental Insurance |
Dental insurance plans are designed to share in dental care costs rather than completely
covering them. All plans have certain coverage limitations including yearly maximums
and annual deductibles. These amounts vary between plans and insurers.
The amount of payments made by insurance companies, allowable fees and other specifics
are governed by each policy and the premiums you pay. Each insurance company and
coverage plan imposes maximum reimbursable amounts for eligible services, known
as “Usual, Customary and Reasonable” (UCR) charges. The insurer pays either that
plan’s UCR limit or an established percentage of the dentist's fee, whichever is
less. Although such limits are called "customary," they often do not reflect what
dentists in the area are charging.
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The fact that a dentist’s charges exceeded an insurance company’s limit does not
mean that you were overcharged. This is because there are no regulations as to how
insurance companies determine reimbursement levels, which results in wide fluctuations.
In addition, insurance companies are not required to explain how their "usual,"
customary and reasonable" amounts are determined.
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Our Insurance Practices
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At Morgan & Rogers Dental, our fees are based upon a combination of direct costs,
time expended, and a constant dedication to providing our patients with the highest
quality dental care available. Our treatment recommendations are never based on
what your insurance will pay, because we believe that your dental well-being should
not be governed by an insurance company. We strive to remain informed regarding
the coverage provided by various plans, but constant changes make this very difficult.
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Dr. Rogers is an in-network provider Delta Dental Premier. |
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As a courtesy to you and your family, we do everything reasonably possible to process
your insurance claims and maximize benefits. However, there are times when problems
arise that only you be resolved between you and your insurance company. On those
occasions, we ask that you promptly respond to any requests so that your claim can
be processed in a timely manner. Please remember that dental insurance is a contractual
agreement between the patient and an insurance company, and the policy holder (patient)
is ultimately responsible for all charges.
Please take the time to carefully review our services contract and do not hesitate
to ask for additional information about our services, billing and payment policies
or dental benefits.
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