The Downsides of Dental Insurance

While dental insurance may seem like a helpful tool for covering the costs of treatment, there are several key limitations that patients need to be aware of:

• Low Annual Maximum Benefits: Most dental insurance plans offer an annual maximum benefit of $1,000 or less. This amount has not increased significantly in decades, while the cost of dental care continues to rise. For necessary treatments like dental implants, which can be more costly due to the complexity and quality of care, insurance may only cover a small fraction of the total cost.
• Insurance Companies Interfere with Care: Dental insurance companies often insert themselves into the doctor-patient relationship, dictating which treatments they will cover and how much they will pay. This interference can prevent patients from receiving the care they truly need. In many cases, the insurance company’s focus is on minimizing their own costs, not ensuring the best outcome for the patient.
• Delayed or Denied Claims: Dental insurance companies are in the business of not paying claims, or at least delaying them for as long as possible. They may reject claims, request excessive documentation, or pay out only a fraction of what was initially agreed upon. This leads to frustration for patients and can create unnecessary delays in receiving reimbursement for their care.

The Risks of Insurance Assignment

Many dental practices accept “insurance assignment,” where they file claims on behalf of the patient and wait for the insurance company to pay them directly. While this might seem like a convenient option, it introduces several risks and downsides for both the patient and the practice:

• Risk of Non-Payment: When a dental office accepts insurance assignment, there’s always a risk that the insurance company won’t pay the claim in full—or at all. In these cases, the patient is left responsible for the remaining balance, but the practice may not receive compensation for the services provided.
• Increased Administrative Costs: Processing insurance claims is a time-consuming, labor-intensive process. Dental offices that handle insurance assignments on behalf of patients must invest significant resources into managing claims, following up with insurance companies, and appealing denials. These administrative costs ultimately drive up the cost of care for all patients.
• Interference with Treatment: Insurance companies can delay or interfere with treatment decisions by requiring pre-authorizations or denying coverage for recommended procedures. This prolongs the process of care and complicates the doctor-patient relationship, often pushing patients to choose less effective treatments simply because they are more likely to be covered.

Our Policy: Direct Payment to the Patient

At Houston Dental Implants and Prosthodontics, we choose not to accept insurance assignment because we believe that the doctor-patient relationship should remain free of outside interference. Instead, we have a simple and transparent process for patients with dental insurance:

• We Help with Insurance Claims: While we do not deal directly with insurance companies, we will gladly assist you in filing your insurance claims. We fill out all the necessary paperwork and submit it to your insurance provider on your behalf.
• Direct Reimbursement to You: After your claim is filed, your insurance company will pay you directly. This way, the relationship with your insurance provider remains between you and them, without placing the burden on our practice or allowing the insurance company to interfere with your care.
• No Interference with Your Treatment: By eliminating the need for insurance companies to get involved in our practice, we ensure that your treatment decisions are based solely on your needs—not on what an insurance company is willing to pay for. You receive the best possible care without delay or restriction.

You Still Get Reimbursed

It’s important to note that our policy does not mean you won’t get reimbursed for your dental treatment. In fact, patients often receive their insurance payments faster when the insurance company pays them directly. We simply ensure that the doctor-patient relationship remains the priority, and you can still benefit from your insurance plan’s coverage without unnecessary obstacles.

Your Relationship with Your Insurance Company

It’s crucial to understand that dental insurance companies do not provide any actual care or services. Their role is to reimburse you for the treatments you receive, not dictate the treatments themselves. The relationship between you and your insurance company is yours alone—our role is to provide the highest standard of care without outside interference.

Conclusion: Putting Patients First

At Houston Dental Implants and Prosthodontics, we believe in putting our patients first. By choosing not to accept insurance assignments, we maintain the integrity of the doctor-patient relationship, minimize administrative overhead, and focus on delivering exceptional care. Our commitment is to your health and well-being, free from the complications and delays often caused by insurance companies.

Contact us today to learn more about our approach and how we can assist you in maximizing your dental insurance benefits while providing the care you need.