Remember GI Joe where they’d always say:
“Knowing is Half the Battle”
Well there’s two things.
One: kids television shows back in the 90’s almost always had great advice that I still follow today.
Two: when it comes to going to the dentist and payments this is very true!
I’ve been through more than a handful of dentists in my short lifetime and have learned a LOT about insurance.
Insurance policies and benefits can get really tricky when dealing with dentists.
Some dentists are non-assignment and some are assignment.
Assignment Dental Offices
Essentially what this means is that some will take insurance payments on your behalf. This is otherwise known as assignment or assigning your dental health benefits that you’re covered for to the dentist.
Non-Assignment Dental Offices
The other is non-assignment. This means that you pay for your dental procedures on your visit and they will file the claim on your behalf and you’ll be reimbursed a few days later.
Now anyone can clearly see the benefits of assigning your insurance payments over to the dentist.
- Less money upfront and out of pocket, so you can essentially feel like you haven’t paid a dime.
- You don’t have to deal with the insurance companies as much.
- Everything’s pretty much taken care of
Why Assigning Your Dental Benefits Can Be Very Dangerous
I’ve always preferred to visit dentists with assignment payment policies in the past. That is until I recently discovered that not taking responsibility for the payments can really have some pretty large negative effects.
I discovered this recently when visiting my new dentist.
Explanation of Benefits
When visiting a dentist, at the end of your appointment the dental office is obligated to print you out an Explanation of Benefits.
What this is, is a sheet of paper detailing the procedures preformed and how much your insurance company will reimburse you for.
To my surprise my old dentists, even though they were obligated to, never provided this nor notified me that I should be receiving these statements.
The Problem with Assignment & Not Knowing Your Dental Benefits
So what’s the problem you ask? It turns out like in all professions, even medical professions, are managed and run by humans. Humans on occasion get greedy. When this happens they look for ways to exploit the system and make more money.
How they do this is by manipulating your insurance.
When an office doesn’t provide you with your insurance explanation of benefits, you trust them to be honest and only apply the procedures that were performed. You are not aware of what procedures they are telling the insurance company were performed.
When you encounter a greedy dental office that is unethical, not knowing what they are submitting allows the dental office to submit more procedures than were performed.
The problem arises when you go to another dental office and the office tells you that those procedures have already been performed. You know for a fact that it was never completed and you have to wait for your insurance renewal to have it covered.
In my case, I went for a complete examination with my new dentist and they told me you’ve already been billed recently for it even though all I had recently were cleanings with a hygienist and I never even saw the dentist for the complete examination.
How to Ensure You’re Receiving Your Dental Benefits
My recommendations would be:
- Always ask for your explanation of benefits.Doing so shows you all the items that were performed during your visit to the dentists. If you see a complete examination on there and never even saw the dentists, that is a red flag.
- Choose an Dentist with Non-Assignment Office Policies.Going to a non-assignment dental office eliminates the risk that the person in charge of your health has other priorities such as money in mind. I’ve recently discovered that non-assignment practices only have your health as their main objective. They aren’t focused on collecting money or other endeavors that a dental office shouldn’t have as a daily task. My current dentist recently let me know some treatments that she recommended taking care of before they grow into big issues. Amazing since I always felt pain in certain areas and my old dentists always would say it was nothing. I wonder if the lower insurance coverage for those treatments had anything to do with it.
So as fun as it can be to visit the dentist (joke), always remember there is a whole other financial side to it. Eliminate the risk that your dentists may only perform treatments covered by insurance and not required by taking responsibility over your insurance payments. Like I always say to my sisters before their visit to the dentist, if it’s easy today it could be painful tomorrow. Walking out of the dental office without paying can have nasty issues down the road as well.