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Read the Small Print, Don't Blame Your Dentist

Dr. Ron Sherman
January 12, 2018

The next time you get an unexpected bill from your dentist, consider the source. As we move into that part of the season where benefits are up for renewal, it will be important for you to remember a few important things regarding dental insurance:

  1. Dental insurance companies are in the business of doing business. Doctors are finding it more and more difficult each year to have dental insurance companies cover patient procedures that they standardly have paid for in the past.
  2. Some insurance companies have become so difficult to work with that a dentist might rather not see a patient who carries that particular insurance. The time that an office spends defending their patients for coverage of standard procedures has made working with these companies, not worth the expense. At this time many dentists consider the easiest companies to work with to be Cigna, Aetna, and Premera.
  3. “If it’s not broken, we are not paying”.  This is an example of a common problem that dentists run into when they try to process your claim. Although you may have a severe tooth ache, unless the tooth shows signs of decay or is physically broken, the procedure will not be covered by your insurance. Even if the tooth is fractured in multiple places and is the cause of your pain, fractures are not a covered benefit. Evaluators, who have not even seen the tooth, deny these claims because they are very costly to the insurance company.
  4. Yes, you can wait until the tooth is fully broken or until the pain gets too severe to withstand, however by that time, your dental bill could double in cost because you now likely need more dental work.
  5. Remember, if the benefit is not upheld by your insurance company, it is your bill to pay. Your dentist is merely a third party to the contract between you and your insurance company.

How can we help?

It’s bad enough to have a toothache and have to go to the dentist, but it’s worse when you insurance company leaves you stranded. Dr. Sherman has 27 years of experience and seasoned front office administrators to help you through “the new maze that is dental insurance”. We are dedicated to your happiness, the reason we have been voted “Best Dental Office on the Eastside” for 4 years running! 

Interested in our services? Contact our patient coordinator to get started or call us at 425.391.4964.