One of the great things we do for our patients is provide a complimentary benefits check. While you are able to call your insurance company to obtain your dental benefit coverage, sometimes patients feel confused by the insurance company jargon. We are here to help and educate each and every one of our patients. One of our goals at OC Healthy Smiles is to improve our patients’ lives through education, because in the end, it will help to improve your overall health.
First, find your dental insurance card for your plan. Make sure you are looking at your card for your dental insurance. Medical insurance cards usually don’t usually include dental benefits. Identify your insurance provider with your insurance card and visit your provider’s website. If the provider website allows, sign in to your account and view your current plan benefits. The provider site should have a variety of services to help you learn more about what they offer. If you don’t get enough information from the website, call your insurance and ask to speak to a representative. The representative should be able to let you know if your insurance is PPO, HMO, or a hybrid plan and what your insurance covers.
HMO plans require that you use a doctor who is contracted with the insurance company. PPOs typically allow you to use any doctor or provider. If an HMO patient chooses to go to a doctor that is out of network, it is likely that the insurance will not pay for this visit. OC Healthy Smiles does not want to compromise the quality of care of patients and for that reason, are considered out of network with HMO insurances. PPO plans allow you more flexibility when choosing a provider and specialists.
General exam and cleanings are considered “preventative” care by insurance companies. You will need to check the percentage that the insurance company will pay. If you see that your insurance will cover part of the fees, you would be responsible for the remaining percentage. For example, if it says “80% of preventative” is covered, then you would be responsible for 20% of the exam and cleaning fees.
If you have further questions about your benefits and what your insurance covers, we strongly advise you to give your insurance company a call so they can explain your benefits for you.
We are considered a Premiere Provider with Delta Dental and in-network with Aetna PPO and Anthem Blue Cross PPO. We accept all other PPOs. We don’t accept HMO plans at this time. By not altering our fees based on insurance coverage, we are able to use the best quality labs and dental materials to produce the finest solutions for your dental needs. Our goal is to improve our patients’ lives through quality care, compassion, and education. If you still have questions about your insurance and if our office accepts your plan, then please give our office a call at (714) 422- 0596 and we will perform a complimentary benefits check for you.
We will need you to provide us with: the Policy Holder’s Name, Date of Birth, Member ID/Social Security Number, Insurance Company Name/ Insurance Company Phone Number, Employer Name (if employer supplies insurance).
*Please allow 2 business days for an accurate benefits check.