July 15, 2022

Dear Imagine Dentistry Family,

Because I value you as a patient, I wanted you to hear from me personally that I have decided to terminate my participation with Delta Dental and explain the reasons that prompted my decision.

It has become obvious to me over the past several months that I can no longer continue to provide the personal care and caliber of treatment that you need and deserve under the existing arrangement with Delta Dental. Since I cannot ethically sacrifice my patients’ care, the only other solution is to withdraw from Delta Dental’s network.

I hope you will remain with my practice because I believe the relationship of trust and mutual respect that we have developed is important. If you decide to do so, I will continue to electronically submit claims on your behalf, and Delta Dental will reimburse you directly for dental services based on its fee schedule. Responsibility for payment of my fees will rest solely on you. I will continue to establish my fees fairly and independently, based on the cost of running my office and providing the necessary care and attention to you and all of my patients.

Thank you for giving me the opportunity to provide for your dental health.

Sincerely,
Dr. Ann Coambs

Dental insurance can be tricky.

Let’s try and simplify things for you.

Dental insurance is complicated. This page makes an attempt to explain it in a straightforward way that is easy to understand.
As a consumer, you can save yourself thousands of dollars by taking a minute to understand the information on this page.

All payments are due at the time of your service.

If you have dental insurance, as a courtesy we can help you maximize your dental PPO benefits by submitting your dental claim to your insurance.
Insurance will likely not pay 100%. However, they’ll give you something.
The estimated turnaround for insurance companies to reimburse you is 3-4 weeks.

Whether or not you have dental insurance: Prior to treatment, speak with Imagine Dentistry’s financial coordinator.

This allows you to get an estimate of what your fees will be, and usually gives you many options.

If you have dental insurance, the goal is to maximize your insurance benefits so that you have the least expenses out of pocket.

Imagine Dentistry can show you what the hidden downgrade fees are in your insurance. For example, instead of a white filling – some insurances will only pay for a mercury filling (which we don’t do). Sometimes instead of white crown, they’ll only pay for a metal one.

Imagine Dentistry works hard on your behalf to maximize coverage, in order to want to build a relationship with you based on communication and full transparency with regard to insurance matters.

When you ask for an estimate, the team will inform you of:

  1. The total cost of your treatment.
  2. The procedure codes, so you can accurately discuss the treatment coverage with your insurance agent.
  3. Billing information narrating to the insurance company why coverage should be warranted.

Note that sometimes dental insurance companies will not tell exactly what they will or will not cover with regard to your services.

Even with a “pre-authorization” letter for your service, it is not guaranteed that your insurance company will actually pay for what they said they were going to!

We will do our best to help you. However, given all the information above, realize that any estimate we give you is purely our best educated guess.

Most people think of dental insurance like a security blanket that will cover them in a big emergency, like most other forms of insurance.

It does not work like that.

Dental insurance companies do not intend for their plans to cover all expenses.

Dental insurance is more like a coupon: It usually will get you a discount on common services.

Many dental insurance plans will tell you that their plans will be covered up to 80% or up to 100%.
This is not accurate.
Most dentists will tell you that dental insurance typically covers 30-40% of your average fee. You are stuck paying the rest.
What’s worse: Even if you obtain a “pre-authorization” for a procedure from your insurance company – they can just change their minds and cover nothing!

That depends.
If you get dental insurance as a benefit through your employer, and you don’t have to pay for it: That’s great! Something is better than nothing.
(However, if you have a choice, make absolutely sure to choose a PPO plan – more on that below.)
If you are self-employed, or your employer doesn’t give you dental insurance: Dental insurance is probably not worth paying for.
By and large, most people save more money at the denitst by paying for only the dental services they need, when they need them. In many cases, this even includes the people with insurance!

If you have the option to choose between an HMO and a PPO, always choose a PPO.

A PPO gives you the option to go to any doctor out of your network. An HMO does not.

In general, with a PPO, you sometimes pay as little as 10% more.

It can.  Sometimes it does not.

Dental insurance companies are businesses. Their goal (like any business) is to make money.

Every day, insurance companies find creative new loopholes to deny coverage.

When they do this to you, you are stuck with responsibility for the dentist’s bill.

Wrong.

Even if we get a pre-authorization letter that supposedly “approves” your procedure expenses, at the very top of that letter it say something to the effect of: THIS IS NOT A GUARANTEE OF BENEFITS.

In other words, there’s a big asterisk right at the top that allows the insurance company to go back on their word.

It happens.

Once again: If they do this to you, you are stuck with responsibility for the dentist’s bill.

It isn’t fair.

Every day, we go to great lengths and spend countless hours for our patients with dental insurance, working with their insurance companies and billing on the patient’s behalf.

However, at the end of the day, we have no power to force insurance companies to “do the right thing” and pay based on the necessity of the care, or what’s in the best interest of your health.

Depending on your plan, surprisingly there are times when it’s actually cheaper overall to pay out of pocket.
Some dentists offer discounts for cash and check payments.
Talk to us, and we’ll do our best to develop a strategic plan of action that works best for you.

No.

For most dentists, dental insurance is a headache at best. Many dentists don’t even accept dental insurance anymore!

When dental insurance plans first appeared in the early 1970’s, most plans had a yearly maximum of $1,000

Today (almost 50 years later) most plans still have an annual maximum of $1,000 – and yet premiums have continued to increase.

$1000 in 1970 spending power equates to about $152 in 2018.

Put another way: Adjusted for a 4% yearly inflation, insurance plan maximums should have risen to be over $6,000 per year. Less than 1% of our patients have this.

When a dentist goes out of network on a PPO, it’s usually because they don’t get paid enough by the insurance to make a profit for the work.
If you have a dentist that uses quality materials and the best technology, the dentist often loses money with dental insurance.
As we explained previously, when a dental insurance company decides they don’t want to pay a claim that they previously pre-approved, you get stuck with the bill.
When people have dental insurance, they usually choose their dentist by going online and “throwing a dart at the board” from those dentists that take their insurances in-network.
The problem with this is that a lot of dentists that accept “in-network” insurances are driven on a business model where they have to upsell you on things in order to make up for the fact that they lose money on insurances.
That means there can be a lot of hidden charges in your bill. Think of it like buying an airline ticket, where they charge you for baggage fees, snacks, and other ridiculous fees.
Once again: When dental insurance companies refuse to pay for a procedure (despite giving “pre-approval” for it), you get stuck with the bill.
In order to continue giving people the best care, and to save both you and us the time and money – we’ve gone out of network with most PPO insurances.

We’ve put together this whole page on ways you can save money at the dentist. With regard to insurance, make sure to speak with our financial coordinator prior to any major treatment.

In the end our top priority is patient care. This means actual time with patients, quality materials and the latest tech that allows us to do the best work possible.