Stephen G. Blank, DDS
Port Saint Lucie, FL 34986
We want to those patient's that have insurance benefits to maximize their reimburement. We will help by completing and mailing insurance claim forms with the correct coding and any supporting documentation that is appropriate including narritive reports, copies of x-rays and photos.
While we understand that getting your money back from the insurance company is important, we never loose site of our first priority, your dental health. So we do not allow insurance companies to dictate care to us. Patients decide with the doctor what is best and then proceed with care. For this reason, we do NOT participate as in any PPO's as a contracted dentist (employee) of any insurance company. The doctor and patient remain FREE to treatment plan based on the patients needs and desires, not the insurance companies schemes and game playing.
Please understand that dental insurance will never cover all of your dental needs. Insurance is available to help with costs, up to some predetermined limit, typically $1,000 - 1,500 per year. Also understand that insurance companies do NOT have your dental health as their priority, they are in business to make a profit. They do this by collecting more than they pay out to you. They are very good at making money. That is good for them, but may not be so good for you.
What does UCR mean. Great question! It stands for Usual, Customary and Reasonable. We often refer to it as "Usually Crummy Repair". It is an artifical number that insurance companies created to minimize what they pay out. Insurance companies can get together and set these numbers, they enjoy an exemption from anti-trust laws! If you ask your insurance company for supporting documentation of their UCR fees, you most likely won't get an answer. UCR is a means of insurance companies maximizing profit at your expense.
What is LEAT. It is an insurance company term for "Least Expensive Alternate Treatment". It is another tool insurance companies use to avoid payment for certain procedures. It may be written in your contract. You may be a victim of LEAT. An example would be: Denial for a fixed bridge or implant, and instead being reimbursed as though a removable partial denture was placed. They call that "re-coding". If a doctor "re-codes" they call it insurance fraud. If an insurance company recodes, they call it good business (for them). Insurance companies have successfully found a way to reduce what they pay out. The insurance company executive would not settle for LEAT if he/she were in the dental chair!
What happens to any un-used benefits at the end of the year? Any benefits you have paid for (or your employer paid for) are lost at the end of the year. If you only have one cleaning (hygiene visit), tough luck, you lost out. If you need $200-300 of care, they keep the rest. It's like leaving cash on the table in Las Vegas and walking away! If you need care, and you have benefits remaining, use it or lose it.
Call to get started today!