Payment options that’ll
make you smile.
We are an unrestricted provider with many dental insurances, which means our treatments are dictated by what is best for our patients and not by the insurance companies. Although we are not in network with a lot of insurances, we will gladly prepare the necessary documents to help you get reimbursed for procedures covered by your insurance provider. For payment convenience, we accept Visa, Mastercard, Discover, American Express, and personal checks. We also offer third party financing as well as short term in house payment plans. Additionally, we also have an in house membership plan which has some amazing benefits!
Q) What do you mean by in-network and out of network?
Q) Why would you not be in-network?
Our patients are obviously why we do what we do and why we exist. Providing the best care possible for our patients is not an inexpensive task. The training, materials, equipment and time that goes into providing the best care possible is only getting more expensive. If we limited our quality of care to the level that insurance actually reimburses us for, we would not be able to provide the same experience and care for our patients. We would have to squeeze more appointments into our schedule and be forced to spend less time with our patients. Just like any office, we sometimes get busier than we would like, but that is due to unforeseen complications during treatment, or trying to accommodate patients experiencing a dental emergency.
Our doctors could not do what we do without our amazing team of hygienists, assistants and administrators. Due to the rising cost of living and historical inflation, we want to make sure our excellent employees are appropriately compensated. Even though these rising costs and inflation are well known and apparent in all aspects of life, insurance companies have not increased our reimbursements in over 10 years. We care about our team and want to be able to offer them competitive benefits, bonuses and salaries. We also want to make sure our team can enjoy their free time with their friends and families, and enjoy the beautiful area that we call home.
There are certain reasons that patients choose our dental office to be their dental home. We like to think that the reason you have chosen us is because of our providers, team, and how we run our business. We value each and everyone that walks in our doors and want to ensure the perfect experience for all, patients, team members and the cleaning crew alike.
These are the qualities that matter to us and our practice. These are not qualities that matter to a dental insurance company. We have made the decision not to change our business practices and clinical care to mirror the greed of insurance companies. For our practice to stay true to our values, we need to remove ourselves from the inequitable relationship of being an in-network office.
Q) What if my insurance doesn’t have any OON benefits?
If your insurance has zero or minimal OON benefits, you can ask your insurance carrier or employer to add to or improve that. Not only would this increase the amount of benefit you may receive at our office, but we have heard from quite a few patients that this gave them a better understanding on how their insurance worked and helped maximize the benefits. Having OON benefits gives you more flexibility and choice as to what dental office you see with minimal change in costs. While improvements in coverage between different medical plans can mean a large increase in monthly cost, the cost difference between dental plans is comparatively small. Alternatively many of our patients have chosen to take advantage of our LB Wellness Plan, which is financially lucrative for many patients compared to most private dental plans otherwise available.
- Yes, there are! As opposed to paying monthly premiums to a third-party insurance company, our LB-Wellness plan is an annual program including 2 cleanings, unlimited exams, unlimited x-rays (including CBCTs, not covered by any insurance) as well as annual fluoride application! You get all this and an additional 10% discount on all treatments, irrespective of if its elective, emergency or cosmetic! We have got you covered! There are no waiting periods, no missing tooth clause and no wait to hear back from the insurance if they will help you or not!
- Even if you can find a “high-end” dental insurance plan, there is still a lot of fine print and restrictions/exclusions involved with the plan. With our membership plans, there are no restrictive fine print! You get what you sign up for!
Since there are thousands of different insurance plans (another way insurance companies create confusion for both patients and offices), it is impossible to answer that question on a broad scale. Some plans do have less coverage for out-of-network offices, but that is because of the details of that particular plan. Almost all dental insurance plans can offer OON benefits, if requested. If you’d like to know how this change will affect you and your plan, specifically, we are happy to help you with getting you a basic breakdown of your plan’s out-of-network coverage. Please email our office at admin@LB-Dentistry.com and allow 2-3 weeks for processing as some insurance companies can be slow in sharing the details
We are also happy to submit a predetermination prior to treatment, but please keep in mind that dental insurance pre-determinations are not a guarantee of payment. They are often based solely on plan benefits without review of x rays, clinical notes or other supporting documents.
Q) How much will it cost me to get treatment?
Q) Do you offer any financing & other options for helping pay for dental treatment?
- Yes, depending on your needs, we offer third party financing through multiple companies as well as in-house payment plans. It is quick and easy to qualify for the third party financing and we will help guide you through the process.
- The in-house payment plan is a short-term payment plan that many of our patients seem to find helpful as an alternative.
- If you are in true financial hardship, there are grants and funds that can help with costs. The Interfaith Clinic in Nashville is a great resource to help take care of oral health needs in challenging times. The Meharry College of Dentistry is another resource for help with dental needs.
Q) What questions should I ask my insurance about my OON coverage?
Our team verifies that your plan is active and collects basic benefit information from the insurance company in order to submit claims and calculate estimated copays but it is ultimately the patient’s responsibility to understand the benefit and network restrictions of their specific dental insurance plan. We highly advise our patients to familiarize themselves with the details of their dental insurance plan. Below are some of the questions we feel are important for patients to ask their insurance company:
What are my out of network benefits?
What’s the Annual Max & Deductible – and what types of services does my deductible apply to?
What are the coverage percentages for: preventive, basic, major, implant?
How frequently will my plan cover: cleanings, exams, xrays?
What is my “plan year” (when does my plan reset each year)?
Is there a “waiting period”?
Is there a “missing tooth clause”?
Are there any material downgrades?
Q) Why would I risk having to possibly pay more to see you when I could just go find another in-network provider?
A large majority of our patients chose us because we are a patient-experience driven office rather than an insurance-driven. We pride ourselves on utilizing top quality materials, current technologies and our incredible team is highly trained to create patient centric appointments. We spend more time with our patients, not less. Because insurance reimbursements are so much lower than the real office fee, in-network providers are pressured to make the decision between quality of care (cutting quality) and increasing production (seeing more patients in less time) to make up for this disparity. We have chosen not to make compromises on quality or time spent with each patient. Your experience truly matters to us.
Q) What is the difference between medical and dental insurance?
The biggest difference between medical and dental insurance is who the out-of-pocket maximum applies to:
- In medical insurance, the patient has an out-of-pocket max
- In dental insurance, the insurance company has an out-of-pocket max
- For example, should you get into a car accident (we obviously hope that never happens, but that is why we have insurance) and end up with a $15,000 medical bill, your insurance (depending on the plan) will usually require a patient to pay upwards of $5,000 then pay the rest of the bill.
- If you have the same scenario, but incur a $15,000 dental bill, your dental insurance will only pay up to $1500 ($2000 on the highest end plans) and you are responsible for the remainder of the bill.
So if you look at it from the above comparison dental insurance is like a coupon that you get to use towards part of your treatment.
- When it comes to pre-determinations (or pre-authorizations) medical insurance will usually stand behind their determination on whether or not a procedure will be covered.
- Dental insurance always has fine print at the bottom of the pre-determination that says “This is not a guarantee of payment”
Dental insurance also takes weeks to respond with the hopes that the patient will not want to pursue the recommended treatment if they need to postpone by several weeks
- Dental insurance always has fine print at the bottom of the pre-determination that says “This is not a guarantee of payment”
