Traditionally, our hygienists spend the month of February visiting local preschools and daycares performing fun and engaging "Tooth Talks" to teach kids how to keep their smiles healthy and strong, but COVID-19 social-distancing precautions have prevented us from visiting this year. So we got creative and put together this fun kid's video that can be enjoyed all year round!
How well do you understand your insurance benefits? Navigating the language and rules of dental insurance can be confusing for both patients and providers! Let's take a look at some insurance basics to help you understand your plan and get the most out of your benefits:
Insurance has a language all its own. Understanding the vocabulary will help with reading your benefits booklet and explanations of benefits.
Explanation of Benefits (EOB) - This is a written summary sent to the provider and to the patient after a claim is processed. It shows what was charged to your insurance, what was covered or denied, and the patient's estimated copays.
Frequency Limitations - Some procedures are subject to frequency limitations, meaning your plan will only cover this procedure a specific number of times in a certain time period. For example, your plan may allow exams once every 6 months or 2 in a 12 month period.
Downgrading - Also known as "alternate benefit." When a claim is submitted, insurance will look to see if a less costly procedure could have been performed as an alternative to what was done, and will then pay the benefits of the lesser procedure, leaving a balance that becomes the patient's responsibility. Insurance commonly downgrades what they consider cosmetic procedures, like white fillings (downgraded to silver).
Deductible - This is the required patient out-of-pocket payment before your insurance coverage kicks in. When a deductible applies to a procedure, it does not mean that your insurance doesn't cover it. Example: If you have a $50 deductible on your plan and you need a $200 filling, you must pay $50 before your plan will cover their percentage of the crown. If insurance covers 50%, that means insurance is estimated to pay $75 ($200 - $50 deductible = $150, 50% of $150 is $75). Once a deductible is met for your plan period, you don't have to pay it again until your plan year renews.
Copay - This is your out-of-pocket cost per procedure. If insurance covers something at 80%, your copay is the remaining 20%. Copays vary by procedure type, frequencies, limitations, and are affected by the deductible.
Now that you're familiar with the verbiage, let's talk about some common misconceptions. . .
Myth: Paying for dental insurance means you shouldn't have to pay out of pocket at the dentist'soffice. TRUTH:Dental insurance functions like a maintenance package for your oral health that helps to offset the cost of basic dental care. It's not designed to cover everything 100%. Most plans have built-in deductibles, co-pays, coverage percentages, and limitations that account for the patient's out-of-pocket expenses. This is called cost-sharing.
Myth: If insurance doesn't cover it, then I probably don't need it. TRUTH: Your doctor is looking out for YOUR unique health needs and will make recommendations in your best interest. Insurance plans are built to cover common procedures for large groups of people. It's reasonable to expect that many people of the same group will have differing medical needs. Furthermore, your doctor's decisions are guided by current research and recommendations from professional organizations such as the American Dental Academy and the American Board of Pediatric Dentistry, which may not be taken into consideration by your employer or insurance carrier when building your plan.
Myth: If I paid my copay at the time of my appointment, then I shouldn't get any bills from my dentist in the mail later. TRUTH: Insurance does not provide a guarantee of payment, ever. The insurance professionals in the dental office will provide as best an estimate as they can based on the limited information that the insurance company provides, however, there are many factors out of your dentist's control that can affect how your claim is processed. A few examples include: if you or your dependents have pending claims in another office or have history in another office during the same plan period, downgrading clauses, and deductibles.
Do you have more questions? The best way to learn more about your insurance is to contact the company directly. Most plans offer web portals with detailed plan information and articles to help you read your EOBs, view claims, and find a provider near you. Or call the customer hotline to speak with a representative.
Does the thought of visiting the dentist fill you with dread? If so, you're not alone! An estimated 75% of adults experience some level of dental anxiety.
Chances are if you're feeling nervous about the dentist, you may be passing the anxiety on to your child as well.
Regular dental visits are an important part of dental health. So what can be done to put parents and children at ease? Actually, a lot! . . .
Choose a board certified pediatric dentist. Pediatric dentists and their staff are specially trained to work with kids. They often foster a child-friendly environment, value a positive patient experience, and talk to children on their level.
The board-certified providers of CDCI would love to take care of your family! Learn more about our doctors here.
Schedule your appointment first thing in the morning, when your child is well-rested. Avoid scheduling near nap times, after school, or close to meal times.
Let the dental team know if you and/or your child are nervous. We're here to help you!
Ask questions. Eliminate the fear of the unknown. Again, then dental team is here for you!
Does the anxiety start before you've even arrived at the office? Try these home tips before your appointment:
Remember that a healthy mouth is something you want for yourself and your family. Close your eyes and visualize your ideal dental visit from start to finish. Picture yourself with a beautiful smile. This practice works well for both adults and older children.
Studies show that visualization exercises have the same calming effects on the mind as mediation. Learn more here.
Help your child understand what to expect from the dental visit by reading a storybook, watching a video, or role-playing with your child.
Are dental x-rays necessary? Are they safe? How often should they be taken?
If you've had questions like these, you're not alone! Here are some of our most frequently asked questions about dental x-rays from REAL parents like you.
Why do we need to take x-rays if my child's teeth are fine?
Many problems begin painlessly and cannot be seen with the naked eye. X-rays enable the doctor to clearly see the anatomy of your child's teeth, gums, and bone structure to check for abnormalities. Treatment is less complicated, more cost-effective, and has a higher chance of a successful outcome when problems are found early, which is why the doctor doesn't want to wait until something hurts to look at it.
Do x-rays need to be taken at each dental visit?
Not necessarily. Every child's needs are different and the dentist will make recommendations in the best interest of your child's oral health.
Why does my dentist recommend taking different kinds of x-rays?
Different types of x-rays are used to evaluate different structures of the mouth. When looking for something small, like a cavity between the teeth, a "zoomed in" view is necessary. When looking at larger structures, like the development of the jaw, a "zoomed out" view is more appropriate. Some x-ray types require different angles and film sizes that help your doctor get the clearest picture of your health in order to make an accurate diagnosis.
I'm worried about radiation exposure. Are dental x-rays safe?
Yes. Dental imaging today is the safest it has ever been. Dental x-rays are already low in radiation because it's not necessary to penetrate through many layers of the body to get to the teeth. Digital x-ray technology lowers the radiation level even further. To put it in perspective, it would take 50 dental x-rays to equal the same radiation as a flight from New York to San Francisco. One dental x-ray is typically the same radiation exposure as eating 2 bananas. Curious what other daily events expose you to more radiation than a dental x-ray? Check out this article to learn more.
It's important to weigh the risks when it comes to radiation exposure. A patient is at a much greater risk of harm from an undiagnosed dental issue than from the minimal amount of exposure in a dental x-ray.
My child had x-rays taken at another dental office 8 months ago, can't you look at those instead of taking new ones?
A lot can change in the mouth over time, and no one can predict how fast cavities will grow and spread onto other teeth. To make an accurate diagnosis, the doctor must have the most up to date information. Seeing is knowing. Not seeing is guessing. Our doctors will not guess when it comes to your child's health.
Do you have a question not featured here today? Please ask the doctor and staff at your next check-up!