There are many opportunities to get the most out of your dental plan. By taking advantage of them, you can lower your out-of-pocket expenses, save time, and achieve a higher level of satisfaction with your overall experience.
When you seek treatment from an in-network dentist you gain several advantages. In-network dentists have contracted with your dental plan to provide you services at a negotiated or discounted contracted rate. They also undergo a safety and quality review process known as credentialing. Using an in-network dentist minimizes your out-of-pocket cost and extends the purchasing power of your benefit plan maximum. In-network dentists bill your plan administrator directly so you won't have to file a claim form to be reimbursed for out-of-pocket costs.
There are occasions when recommended dental treatment gets expensive. A pre-treatment estimate can help you know how your plan will cover the recommended treatment so you understand your expected out-of-pocket cost before treatment begins. A pre-treatment estimate may also help you identify less costly treatment alternatives with your dentist. Most dental offices will typically submit a pre-treatment estimate on your behalf.
HSAs and FSAs are savings accounts offered alongside qualified plans that provide tax advantages for eligible out-of-pocket healthcare costs. Money in these accounts can be used to pay for deductibles, co-payments, coinsurance, and other qualified healthcare expenses. Because of the tax advantages, these accounts can help you save money when you use the funds to pay for eligible out-of-pocket expenses. Because of the tax implications associated with HSAs and FSAs, you may want to consult a tax advisor before you set up or have questions about how these accounts work.
Some dental offices will file dental claims on their patient's behalf, especially in-network dental offices. However, some do not, including many out-of-network dentists.
Filing your own dental claim is cumbersome. You will have to obtain all the service information from your dental office to include with your claim. In addition to procedure codes and the dentist's charges, your plan may also request a dentist include such things as X-ray images and treatment notes. If the dental office does not file your dental claim for you, you may want to consider using an in-network dentist, as in-network dental offices will submit your dental claim on your behalf.
In addition, a growing number of dental plans process claims in real time. When this service is available, it enables you to immediately understand your out-of-pocket cost obligations and settle your bill before you leave the dental office.
For a faster, more convenient experience, take advantage of the resources your plan and dental practice provide. Many plans and dental practices offer services such as:
Last updated: 12/7/2022
© P&R Dental Strategies, LLC D/B/A Fluent. All rights reserved.
