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I can't claim credit for this analogy, but it's a pretty good one, so I thought I'd follow up my last post on dental insurance, what it covers and what it doesn't, with this example of how crazy it can be. Imagine you are the manager of a Target Store. And in that Target, you have 600 items you sell.  Everyone who comes into your Target on any given day has a different price they are supposed to pay for these 600 items. For many of these items, neither you nor the customer know the exact price, and the company with whom you have contracted these reduced fees for the customer won't divulge the information, so you have to guess.  Not that this isn't already tough enough, but each of these customers has an Uncle who is going to pick up a portion of the elusive price, and it is your job as the manager to know exactly what portion the uncle is paying -- assuming he will not deny it saying that they didn't really need it!!  Furthermore, you are supposed to know exactly where that uncle lives, and bill the uncle for the share he is going to pay. On top of this, the customer expects you to get it exactly right, every time, or they get upset. And THAT, folks, is what it's like dealing with dental insurance from the dental office side.  ;-)  

Dental insurance is an interesting issue today, and it's often a complicated one that confuses many patients.  Heck, sometimes it even confuses us!  Therefore, I'd like to offer a little clarification on what dental insurance is and isn't, what it covers and what it doesn't cover, when it's worth having and when it's not, and what you can do to make your life and ours a lot easier, smoother, and more trouble-free when it comes to your dental benefits. First and foremost: DENTAL INSURANCE IS NOT LIKE MEDICAL INSURANCE!!!! I really can't stress this enough.  With medical insurance, you pay your copay, and your insurance pretty much covers everything after that unless you go out of network or it's something unusual.  With dental insurance, you typically only get a certain amount of benefits per year, usually $1,000 - $1500. If you're really lucky and have a great employer, it might be as high as $2,000/year. What does "UCR" mean, and is it really what it says? "UCR" stands for "Usual, Customary, and Reasonable" fees.  Here's the problem that most people don't understand......every single insurance company determines what THEY think UCR should be, it varies by the ZIP code of your doctor/dentist, and not only will insurance companies NOT tell us or you what their UCR fees are, but they also don't even reveal how they calculate them. Obviously, this makes it much more difficult for us to accurately estimate what your co-pay will be, and unfortunately, it often means you end up with a remaining bill after insurance pays less than we originally expect.  The GOOD NEWS is that we have recently updated our practice management software to the newest version, and it has some [...]