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Our office manager, Deborah, is here to assist you in obtaining the full benefits to which you are entitled under your dental insurance plan. There are hundreds of dental insurance plans. It is impossible to know in advance exactly what your benefits will be. We encourage you to bring your benefits books to your first appointment so that we may help you better understand your particular policy. You may want to call your insurance carrier and inquire as to what is your yearly maximum, and how much of that amount has been used so far this year.
We will complete all your insurance paperwork in a timely manner and make the process as easy as possible for you. Your dental insurance company will work to limit your coverage through the use of annual limits and Usual, Customary and Reasonable fees (UCR).
Before Dr. Rattner begins any treatment, he will provide you with an estimate of the cost of treatment. Dental insurance is not meant to pay for all the procedures at full fee. Unlike medical insurance, dental insurance has very low yearly limits on benefits. Most plans have a yearly maximum of $1,000-$1,500. This limit has not changed in the last 20 years. If the annual limit had kept up with inflation (as you know the insurance premiums have), it would be over $5,000 today.Your employer does not tell you that your dental benefit is being reduced every year, but in reality it is, because the maximum does not keep up with inflation.
Insurance companies use UCRs to limit their payments to you. For each procedure, the insurance company selects a UCR fee. From that fee, they decide that percentage they will reimburse. For example, a plan with a high premium may set the UCR for a filling at $125. If the employer wants a plan with lower premiums, the insurance company will set the UCR lower, say at $85. Your plan booklet may say that they reimburse at 75% for fillings, but it is 75% of a number chosen by the insurance company. By lowering the UCR, the insurance company reduces the cost to the employer (lower premiums) but increases the cost to the patient through higher out of pocket expenses.
Quite often wee see a variety of UCRs from the same insurance company for patients from different employers. When the fee exceeds the UCR chosen by the insurance company, they will tell you: "The fee charged exceeds the usual, customary and reasonable fee charged in your area." It would be more accurate to say, "The employer chose a plan that does not reimburse at the level charged by most dentists in the area."
Our fee is not based on the insurance company's definition of UCR. The level of service and care you receive does not vary depending on payment by the insurance company. Our fees are based on the skill, time, judgment, care and office environment provided by Dr. Rattner and his staff. We strive to consistently provide the best care available anywhere in the world on a daily basis.
RECONSTRUCTIVE PERIODONTICS • DENTAL IMPLANTS • BOYNTON BEACH • FLORIDA