Читать книгу Dental Letters: Write, Blog and Email Your Way to Success with CD-ROM - American Dental Association - Страница 7

Date

Patient Street Address City, State Zip

Dear Patient:

Whether you’re new to our practice or have been a valued patient for years, it’s important to be reminded how most dental insurance plans work. I would like to take this opportunity to explain why your insurance may not cover the entire cost of your dental procedure, or why it covers some dental procedures and not others.

Most dental benefit plans are the result of a contract between an insurance company and your employer, union or association. The person who negotiates the terms of your insurance plan makes the final decision on maximum levels of reimbursement through a contract with the insurance company.

Sometimes it may be noted on your bill that the fee I have charged you is higher than the reimbursement levels of UCR. It does not mean that our office is overcharging you — it could mean that the insurance company may not have taken into account up-to-date, regional data in determining a reimbursement level. Even though the cost of dental care has significantly increased over the years, the maximum levels of insurance reimbursement have typically not increased at the rate of inflation since the late 1960s.

Other plans may want you to choose your dental care from a list of their preferred providers. Choosing your dental care provider from this defined group can affect your levels of reimbursement. Your plan may also tell you that they will only pay benefits for the least expensive alternative treatment for a condition, or deny coverage for conditions that existed before you enrolled in the plan.

A deductible is the amount of dental expense for you are responsible for before your plan will assume any liability for payment of benefits and could increase your out-of-pocket expenses. In addition, many plans do not provide coverage for all dental procedures. This does not mean that these procedures are not necessary — it just means that your employer has purchased a plan that does not cover the cost of providing coverage for these services. Please discuss all treatment decisions with your dentist.

I hope this letter gives you a better idea of why your insurance may not pay 100 percent of your dental costs. If you have specific questions regarding your plan, or whether a specific procedure will be covered, contact your insurance provider or the human resources department of your employer to discuss the details. As always, thank you for being a valued patient.

Sincerely,

Dentist