Frequently Asked Questions

You got two different answers because it's two different questions. Over 50% of our patients are insurance patients. We are providers for about 2%. So 98% of our patients are out of network. We do accept almost all insurances. The patients who come to us and have insurance know we're not in network with their insurance. The insurance companies note it on every explanation of benefits (EOB) they send the patient. We expect that each patient knows something about their dental plans. And if they do know something we would think they know who is in network. It's listed on insurance company websites. And often that information is provided by the employer. But what you wouldn't know from your carrier (insurance company) or employer is whether or not we accept your insurance. Only we know that.

Since we are unwilling to bow to the coercive tactics insurance companies use designed to control us and cut our fees they are unwilling to provide us with fee schedules so that we may accurately estimate our patients' co-pay. They know this is unhelpful to their members. But what is more important to them is to make it hard on dentists who refuse their meagre offerings.

If you don't use your benefits before the end of the year (the end of the year for your plan may not be December) you will lose what is remaining. It's important for you to know when your plan rolls over so that you can maximize your benefits. Most patients do not use all their benefits each year. If you have benefits in the amount of $1,500 (average coverage) one might think that coverage wouldn't last. But the way insurance companies manage those plans with deductibles, frequency clauses, waiting periods, down-grading, bundling and a host of other tactics designed to not pay, it's a wonder the benefits ever get used. 

None. In theory, a dentist participates as a provider for a insurance company and that insurance company refers patients to the dentist. In reality, there is no active referral system. They do post participating dentists information on their websites. But if there are several dentists participating in particular region they will all be listed as "preferred" dentist. This being not much better than a regular google search. For this you lose control to decide what is best for the patient with the patient. Instead an insurance company far removed from the process of reviewing charts, speaking to the patient, examining the patient, and knowing the patient is who decides treatment. Oh, and a pay cut that only helps the insurance company. When I decided to become a dentist this wasn't what I had in mind.

That's what we're led to believe. However, what's not talked about is how patient care diminishes when the patient load increases. When i stopped participating in the first networks, I was able to see fewer patients, spend more time discussing treatment. I was not running room to room too busy to even know who was in the next room. Every dentist knows the more time you can spend with a patient, the better the treatment. Many patients understand this too. We've all seen the "dental mills" where the waiting room is full. Every operatory is full. the doctor and the hygienist are behind. These are the participating dentist clinics. And when the insurance companies second guess our treatment plans; often making is sound like we're taking advantage of patients, it gives the impression that the administrators are saving the patient from a greedy dentist when in fact they are often preventing the patient from getting the BEST treatment for them at that time. There's a cost for not getting the best treatment. I stand by every diagnosis I've ever made on a patient. And I've spent countless hours defending that treatment to people who knows nothing about my patients. Then I have to ask: Who's looking out for your welfare? An insurance company who you've never met? And knows nothing about you? Or your dentist? Someone who knows your kids names, and what they look like? Someone who likely knows you from the community? Someone who looks you in the eye and tells you that they care about your oral health? If you picked the insurance company then a dental mill is right for you. And you will get what you pay for.

When a new dentist is ready to start a practice they typically owe for their education. Mine was over a 1/4 million before i even spoke with a banker about a loan for a practice. My practice indebted me a million on top of the school debt. Now you have well over $1,250,000 and you don't have a single patient yet. It's scary. Insurance companies exploit that fear to get the dentist to enter into a one-way business arrangement. Of course, the new dentist doesn't know how bad the deal is yet.

The short answer is yes. My problem is I didn't go into dentistry to work for an insurance company making them richer at my expense. When you take a up to 50% fee loss you have to see twice as many patients as you otherwise would. And this often means rushing through treatment. Hurrying out of the room to see another patient while the patient you're leaving feels short-changed. Additionally, insurance companies second guess treatment. And they don't do this for the benefit of the patient. Often acting as though the dentist is doing unnecessary work on the patient. They word this very carefully, but the result is often the patient accusing the dentist of taking advantage. When really it's about them wanting to do the least acceptable treatment to save them money. Mostly the least acceptable is not what is best for the patient. And they make these determinations without ever examining the patient.