Frequently asked Dental Questions Denver Metro area including Highlands Ranch Colorado

Please feel free to contact Highlands Ranch dentists Dr. James DeLapp or Dr H. Caqndace DeLapp with your questions. Our office offers a no charge consultation to address your questions. At this visit we can give you an "idea" of what options you are looking at for your dental needs and an "estimate" on projected costs. You get to meet the doctors and see if our office is for you.

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Dentist Highlands Ranch

Our goal is for you to understand the benefits and “limitations´ of your insurance. Being disappointed by coverage is no fun and knowing ahead of time the limitations of coverage keeps everyone happy. Your policy may be the finest or one that is in the low end of benefits. You may need to make this decision;

“will I still make this decision to proceed with treatment at Cottonwood Dental Group even if my insurance will not cover it?

If the answer is yes… then lets get scheduled right away. If the answer is no… take the time to investigate your policy on the Internet to find the coverage and limitations “before” you schedule with us or anyone else. We don’t want you to be disappointed after treatment is completed.

q Any plans where there are no restrictions (a list of dentists) on what dentist you may see.

q In addition, certain plans allow you to go “out of network” (the discounted list) but the reimbursement level may be less. This means you will have a greater out of pocket expense ranging from a few dollars to a substantial amount.

q There are literally hundreds of insurance companies and thousands of variations within these companies. To know the details of each is virtually impossible. Understand that this confusion tends to decrease utilization of the plan by the employees and a substantial saving to the carriers.

Philosophically dentist Highlands Ranch

First of all… we live in the United States and we can go wherever we want! No plan can tell you who you can and cannot see! The Catch 22 is they may not assist you in paying for the treatment but truly the choice is yours. The maximums insurance companies cover for dental insurance “typically” ranges $750- $1500. Basically, this helps pay for only minor treatment as this “cap” is reached quite easily. Most of the time dental insurance is meant to cover only basic services.

Is dentistry a commodity or service? Your decision will determine which office you will be happiest at.

If you view dentistry is a “commodity” then you are foolish to pay more for this “commodity”. Why pay 20% more for a tube of Crest toothpaste at one store versus another. If you view dentistry as a commodity then you are best served going to the cheapest provider.

If, on the other hand, you view dentistry as a “service” you need to match your expectations of service with a provider that provides this service. Cottonwood Dental Group and Dr’s James and Candace DeLapp make every effort to provide first –class service in the field of dentistry. The doctors do not double book their patients and have a “reception room” rather than a “waiting room”. They use some of the finest dental labs, take lots of continuing education, use the most up-to-date materials and equipment, and try to provide the best dentistry they are capable of… on time! Unfortunately, in order to fly first-class the cost to provide these services is greater than the discounted plans provide. If service is most important to you then we may be the practice for you.

Remember…coverage is determined by the premium your employer pays. The higher costs provide more expanded coverage while the less expensive plans cover less or place restrictions on which dentist you may see to have coverage. In general, it is no more complicated than the fee of the plan costs!

In general these plans only have a limited number of dentists who join the program. The cost of the policy is considerably less to your employer and by its nature will cover procedures that are discounted heavily. These tend to be the “chain type” of dental facilities that see a large volume of patients. You may or may not see the same provider twice because this is how this business model is structured. Waits for treatment “can” be considerable and not predictable.

These plans have a listing of dentists who have agreed to discount their fee in order to be on the list of discounted providers (preferred providers). These programs offer benefits if you go “outside” of the network but “will” reimburse to a lower level. What this means to you is you will have more out of pocket expenses. The dentists on these plans have agreed to be on this list because they feel this listing will give them a greater volume of patients and will by necessity have to see more patients and customized treatment is more difficult to do.

Type III dental plans (most cost to your employer). We participate with these plans!

This type of plan allows you to visit any dentist and be reimbursed regardless of whom you see. Frequently these plans have a “cap” or maximum payable amount for a particular procedure that may or may not fit into what most dentist charge. These are the types of plans that Dr. James and Candace DeLapp participate in. We feel these are the first-class plans by in large.

UCR what does it mean?

UCR stands for “usually… customary… and reasonable”… which may not be further from the truth. The American Dental Association has fought this terminology for years because it connotates that certain dentists are unreasonable with their fee. An insurance company may cap a fee for a certain procedure at the 50^th percentile, which means that 50% of the dentists would fall outside of the customary… reasonable fee. These “UCR fees” at times can be arbitrary and even within the same insurance company the UCR “may” pay differently. What is frustrating for the patient and dental office is when literature put out by their insurance company states they pay for a service at 100% but what they really mean is they pay 100% of a capped fee. It all depends on if your employer chooses a plan that has higher limits. Of course this costs more for you employer to get the “better” plans.

Predetermination of Benefits means?

Does your human services personnel may view dental service as a commodity or a service? As discussed above, if they view it as a commodity they will steer you to the cheapest provider. If service is your concern, you may wish to investigate your policy online. You can obtain information about your policy that dental offices may not be able to access. Since we are not a party to the contract, we (dental offices) get limited information. Armed with this information you may be able to make a better-informed decision that our office is the dental office for you.

Even if we receive a pre-determination of benefit this does not mean the insurance company will pay for the service! To quote many plans:

q “all claims are subject to the terms and conditions of the subscriber’s contract that is in effect at the time the service is rendered and may, or may not be payable based upon meeting them” and…

q This statement is provided to you for information only(meaning they are not legally bound to the treatment)and…

q “Your plan covers the least expensive treatment … meaning they will not cover white fillings only silver/black amalgam (silver combined with mercury) restorations

Why we have you pay date of service for amounts under $350.00.

In order to accept assignment of benefits for amounts under this amount we would either have to hire more staff to hunt down these benefits or see a greater volume of patients and double book. This results in less customized service to you. Since you are the owner of the insurance policy the company tends to pay you much more promptly than the doctor’s office (regardless if it is medical or dental). We find your reimbursement runs around 10 days or less while we have been on the insurance companies wait list for up to six months. Simply put, businesses cannot run when they are paid for service six months later.

We understand that dental care can be expensive. Here are some alternatives to decrease its impact.

q There are several options for financing available. “CareCredit” offers both interest and no-interest payment plans. Obviously, it can be used in our office but also can be used in participating offices for Veterinary Medicine … Cosmetic Surgery… Hair Restoration… Weight Loss to name a few. They offer from 3 months to 60 months programs. CareCredit can be used like a credit card and they can be reached at (1-800) 365-8295 or their web- site at www. Carecredit.com

q The other option is“Capital One Healthcare Financing”. This program tends to have lower interest rates depending upon your credit score. We have had patient’s call both ahead of time to secure financing some even before their first appointment. Capital One can be reached at (877) 559-5050 or their web site at www.capitalonehealthcarefinance.com

Frequently Asked Dental Questions

Philosophically dentist Highlands Ranch

Is dentistry a commodity or service? Your decision will determine which office you will be happiest at.

Remember…coverage is determined by the premium your employer pays. The higher costs provide more expanded coverage while the less expensive plans cover less or place restrictions on which dentist you may see to have coverage. In general, it is no more complicated than the fee of the plan costs!

UCR what does it mean?

Predetermination of Benefits means?