Westpark Helpful Dental Articles
The Secret Language of Dental Benefits—Insurance Coordinator Tells All
When a patient tells me, they want to be smart about their insurance and make sure they are choosing a company that will cover them in the best possible way, I offer my services to the patient. Whether it is a new patient in our practice who is planning their first visit with us, or if it is a patient of record, I always offer to talk about their insurance. When a patient’s plan is going to change or when they have the option to pick a new company of their choice, before a patient signs up for that insurance, I am here to help them understand the benefits as well as the secret language of the insurance world.
The secret language of insurance includes knowing that policies often have waiting periods that apply to certain benefits when a patient is switching companies or getting insurance coverage for the first time. These waiting periods are normally six months or twelve months. There are also clauses for a missing tooth. In some cases, if the patient has had a tooth extracted previously or is missing teeth, the insurance company may not cover a dental implant or a bridge to replace the missing tooth or teeth.
In terms of timing, within the insurance policy year there are limitations of coverage. One of the services I provide is helping patients understand that they can plan for treatments to coincide with plan years and maximize their benefits—which is financially very helpful to patients. As the year draws to a close, we try to make sure that they accomplish any treatments they need in different calendar years if possible, to maximize their benefits. They can start some treatment in December and have additional procedures completed in January, for example—as long as the sequence makes sense clinically and is approved by the doctor and is also agreeable to the patient. I enjoy helping patients coordinate their treatment timing in this way when feasible.
Molly MacBride, Insurance Coordinator
West Park Dental
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