Insurance & Billing

• AETNA PPO
• AMERITAS
• ASSURANT SUN LIFE
• ANTHEM (BLUE CROSS BLUESHIELD 300 & Complete Plans only)
• CIGNA
• CONNECTION DENTAL
• CONNECTICUT GENERAL DENTAL INSURANCE
• DENTAL HEALTH ALLIANCE (DHA)
• DEAN (TMJ provider only)
• DELTA DENTAL PPO AND PREMIER
• DELTAL DENTAL (OF MANY OTHER STATES)
• DENTAL BENEFIT PARTNERS
• DENTAL CARE ADVANTAGE
• DENTAL WELLNESS PARTNERS
• ECHO HEALTH
• GEHA
• GUARDIAN
• FORTIS
• HUMANA
• METLIFE
• PREMIER
• PRINCIPAL
• UNITED HEALTHCARE (UHC)
• WEA

• MEDICAL ASSISTANCE
• FORWARD
• BADGER CARE
• MEDICAID
• PHYSICANS PLUS
• UNITY
• MOMENTUM

We may be part of your dental plan. Please contact your insurance company or your Human Resources Representative at your work and see who your dental plan is administered by. Example: It’s not uncommon to see a smaller insurance company outsource or have it administered by a larger company.

If you have a questions regarding who administers your dental plan, please contact your plan directly.

With a Delta Dental PPO dental insurance plan, unlike with an HMO, you do have an annual deductible and maximum. However, the deductibles are very small; they can range from $25 to $100, and only need to be met once per benefit year.

When you visit a dentist that is in network for your Delta DentalPPO dental insurance plan, you may still pay a co-insurance (percentage) of certain services, but because of this contractual agreement, the difference between the office fee charged and the allowed amount is written off. With aDelta Dental PPO dental insurance plan, these contractual fees are usually much lower than the fees being charged at the majority of dental offices.

Delta Dental PPOs are great for the patient! Please contact us with questions about your Delta Dental PPO plan. We are happy to answer questions about Delta Dental PPO.

At your initial appointment we ask that you arrive at least 15 minutes early for paperwork and registration. Once your paperwork is completed, staff will add it into our system, which includes storing your individual dental insurance plan in your account.  We do require that you bring your dental insurance card to this appointment as nearly every patient’s plan is different.  It is not required to bring the card to subsequent appointments unless your insurance company has sent you a new one; however we will ask at each visit to ensure there have been no changes to your coverage.

Sometimes insurance plans change, whether it’s because your employer updated the plans they offer or even something as simple as your subscriber number changing.  Not all changes require the insurance company to give you notice, therefore we must ask at each visit for an update on your insurance status. This way, even the smallest change — including those you don’t know about — won’t delay your claim status.

There are many reasons that your dental insurance claim could be denied. Denials can be explained on your EOB (Explanation of Benefits). Simply reference the reason code, or call your insurance company for more details. Some common reasons for claim denials are:

• The procedure performed is not a covered benefit (refer to your insurance handbook to ensure coverage before having any work completed)
• Your annual maximum has been met
• The subscriber number or group number provided to us was incorrect
• There is a waiting period on the work you received
• The patient’s date of birth at our office is different than what is listed at the insurance company

If your question is not answered here, please call us and we’ll be happy to assist you.