Choosing a Dentist based on Dental Insurance

The practice and business of dentistry along with insurance has changed in the past several years. Choosing a dentist is a very important decision. A person has only one set of adult teeth and these teeth need to last a lifetime.  With proper care and attention, most healthy adults should be able to keep their teeth for a lifetime!

Brushing and flossing are very important to a healthy smile, Regular dental check-ups are also necessary.  One can’t visualize their teeth and determine if there are problems and therefore a dentist is needed to evaluate one’s teeth and gums.

There are many factors in choosing a dentist.  Many select a dentist based on “non-dental” considerations.  Some of these may be location, ease of parking, hours of operation etc.  Some select on “word of mouth” recommendations by friends, fellow workers and family members.  Today, many people select and choose a dentist based on insurance.  Those in the United States that have dental insurance have opportunity to have a portion of their out-of-pocket expense lowered by payment by a third party, dental insurance.

Dental insurance has changed significantly during the past several years. The majority of dental insurance companies today have Preferred Provider Organizations (PPO’S).  These organizations or plans are the primary framework for benefits for those that have dental insurance.  Patients always have a choice when choosing their dentist but it is very highly recommended by the insurance companies that patients choose dentists that are contracted, “signed-up” providers with the dental insurance companies.

If a patient chooses a contracted dentist his out-of-pocket expense is less than choosing a non-contracted dental provider.  But it also a great financial benefit to the insurance company as it pays much less to one of it’s contacted providers than to a regular, non-contracted dentist.  One can easily see why the insurance would want a patient to go to a “contracted/insurance dentist” as it pays much less to one of “their providers” than a “non-contracted dentist” that has no legal/contractual affiliation with the insurance company.   Some estimates are that insurance companies may pay anywhere from 20-60% less to contracted dentists and therefore have much higher profits and make as much as 60% more by patients going to their selected contracted providers.

Dentists are solicited by insurance companies to “sign-up” to become providers with the insurance company.  Insurance companies will lead dentists to believe that they will gain new patients by being a preferred provider.  But that comes at a cost to the dentist.  When a dentist signs the, many times, multi-page contract with the insurance company he agrees legally and contractually to a schedule of fees that may be 20-70% less than their normal fees for services.  Therefore, a dentist provides services that are discounted to the patient and insurance company of many times half price or more.

Some thoughts to consider when selecting a dentist based on Dental Insurance….

* Would you select a dentist that has a contract with your dental insurance company for fees charged?

*  Do you feel comfortable with a dentist that has a legal/contractual relationship with the insurance for dental services?

* Keep in mind that your coverage and choices may be limited due to contract(s) between a dentist and the insurance company on your behalf.

* In-network, contracted dentists have, by contract, many guidelines set forth by the insurance companies that may affect your dental care.

* Out-of-network, non-contracted dentists have no direct limitations set forth by an insurance company that would affect your treatment or choice.

* Out-of-network dentists have no contractual relationship with insurance companies and are not directly limited and dictated by an insurance company.

We hope that this information has been helpful to you as you look at dental insurance as criteria in selecting your dentist for you and your family. Dallas Texas dentist, Dr. William Miller is an experienced general dentist that has been providing his very best in personal,  quality focused dental care for over 30 years.  He works with one patient at a time so that he and staff may devote 100% of their time to YOU during your scheduled visit.  Dr. Miller practices dentistry as an Out-of-Network provider for all insurance companies.