It is the goal of the Atlanta Dental Group PC staff to assist our patients achieve the very best dental health possible. Dental insurance can help patients overcome some of the financial barriers to obtaining good dental health, so we actively assist in battling the obstacles placed before patients by dental insurance companies.

          Most dental patients know nothing about dental insurance. Health and human service specialists do not fully understand insurance policies and they often create problems because they buy policies for their companies. Dental insurance companies take advantage of this lack of dental knowledge and make profits from it.

          If you have dental insurance, as a courtesy, the staff of the Atlanta Dental Group, PC will process your insurance claims, in most cases, electronically. Since each plan varies considerably, we cannot always accurately assume what your insurance will cover, but we will try our best to help answer any questions you may have. The final responsibility for payment is yours.

          Dental insurance is intended to cover a portion of your dental treatment charges. The amount of coverage you have depends on the contract your employer has with the insurance company. What your dental insurance company pays depends on many factors including deductibles, maximum allowable benefits, substitution clauses and exclusion clauses.

          The Atlanta Dental Group, P.C. staff will call your dental insurance company and get a breakdown of your dental benefits, but because the insurance company will not guarantee the coverage, so we can only provide an estimate for you. We treat you and not your dental insurance company, so it is your responsibility to pay anything that your dental insurance doesn't. Your portion of the bill can be paid by cash, check or credit card.

         You are welcome to make a financial consultation appointment by calling 404-874-7428 and asking to speak with our Financial Director.

         Our staff can assist you in finding dental insurance coverage. However, insurance companies are not stupid. Why would a company choose to knowingly lose money by paying out more money than you pay in? Companies don't do that.

          Most individual dental insurance plans require a patient to wait one year before the dental insurance plan will pay for major services. So you have to carefully plan your future treatment! Most patients are in too much of a rush and want everything done right away but that's not how dental insurance plans work.

          Because of this one year dental insurance waiting period, smart patients should obtain a dental loan for treatment needed immediately and then delay any optional treatment until the next year when their new dental insurance plan begins covering major services.

          It is much easier to obtain group dental insurance plans than individual plans. Insurance companies know that most people don't use their dental insurance so it's easier for the insurance companies to make a profit. Group plans often to not have a year waiting period.

          Small businesses should consider retaining the services of a payroll company. These companies take care of all your governmental needs and also provide excellent medical and dental insurance options. If you are an employer and would like help choosing the best dental insurance plan for your company speaking, you should consider speaking with our Financial Director. We know the differences between most dental insurance plans because we deal with them daily.

          The average American dentist has an office overhead of 71%. This means that when a patient pays the dentist $ 100.00, the dentist keeps $ 29.00. If a dental insurance company forces the dentist to take a 25% discount off his fees to be part of this dental insurance company plan, the dentist makes $ 4.00 for every $ 100.00. The dentist can get paid better working at McDonalds.

           Why would a dentist do this? One way is for the dentist to make up in volume. If the dentist normally sees one patient an hour, he now has to see three patients a hour. The dentist may add more charges to the patients bills to make up for the lower payments.

          Dentists that take limited plans work harder than dentists who only take traditional plans. Do you want to go to a dentist who is working harder and can't spend much time with you?

          Limited plans are called Dental Maintenance Organizations ( DMOs ) or Preferred Provider Organizations ( PPOs ). There are a limited number of dentists on these limited plans and it is harder to get a dental appointment because there are fewer dentists on the plan. You have to go to the company dentists.

Annual Maximum
This is the maximum amount that your dental insurance will pay for the cost of your dental treatment in a year. Most companies use a calendar year which begins on January 1st and ends on December 31st.

Claim
A dental insurance claim is when you ask your insurance company to pay their part of your dental treatment. It's a request for payment.

Co-Payment
This is your share of the bill after your dental insurance has paid their part. It's what you pay out of your pocket for your dental treatment.

Deductible
This is the amount of money that your dental insurance company deducts from their payment to the dentist or to you.

Exclusions
These are the dental treatments that your dental insurance company will not pay for. The most common exclusion is not paying for bridges to replace teeth that were removed before you got your dental insurance.

Family Coverage
This is a policy that covers the whole family, not just the employee. Read your application carefully to be sure you are choosing the plan you want. If you choose family coverage, your whole family will be covered. The bigger your family, the better the bargain.

Frequency Limitation
Frequency means how often something happens. We have a birthday once a year so the frequency of our birthday is once per year. Dental insurance companies have frequency limitations for cleanings, bite-wing x-rays, replacement of a crown, replacement of a partial or complete denture and more. Most dental insurance booklets do not completely inform patients of these frequency limitations.

Fiscal Year

Some dental insurance companies us an artificial year that the dental insurance company creates. The year is 365 days just like a calendar year, but the year begins and ends on a day other than January 1st. For example, teachers many begin work on September 1st, so their dental insurance company may begin the teacher's dental insurance on September 1st and end the year on the next August 31st. This really confuses dental insurance payments.

Limitations
Most dental insurance companies limit you to only a certain amount of dental treatment in a certain amount of time. For example, if you want to get a cleaning every month, the company will limit you to one cleaning every six months. You end up having to pay for five of the cleanings yourself because your insurance will only pay for one in six months.

Maximum Allowable
This is the most amount of money that a dental insurance company will pay for a dental treatment or for treatment in a specified period.

Orthodontic Limitation
Most companies will not pay for orthodontics ( braces ) for adults. The dental insurance company will limit treatment to patients up to the age of 19 or 21. After that age, your company will not pay for any orthodontic treatment.

UCR
This is the maximum amount of money that a dental insurance company will pay for a dental service. If the dentist charges $ 1,000,000.00 for a root canal, your dental insurance company will laugh and only pay for $ 850.00. The $ 850.00 is the dental insurance UCR for the root canal. Every dental procedure has a UCR.

Waiting Period
Are there restrictions in the plan such as age, length of coverage time, waiting periods? Does the plan limit the extent of services or the conditions under which certain services are provided? Are specialists available?

100% Coverage
This is when a dental insurance company tells you that they will pay all of a certain dental treatment. However, dental insurance companies do not tell you that 100% coverage is paying all of what the dental insurance company wants, not what you are charged by the dentist. So a patient often has to pay part of 100% coverage because the dental insurance company usually pays less than what the dentist requests.

          You are welcome to make a financial consultation appointment by calling 404-874-7428 and asking to speak with our Financial Director.