CONSENT OF UNDERSTANDING:
DELTA DENTAL
REQUIRED UNDERSTANDING BEFORE SIGNING YOUR PATIENT PAPERWORK:
At Rooted Dental Wellness, we strive for transparent financial arrangements. Unfortunately, Delta Dental is not very transparent with our patients. Therefore, we require that you read the following information to better understand how an uncontracted dental office works with Delta Dental.
When you schedule your new patient exam, our front desk receptionist can give you an exact price of what that will be. If you have Delta Dental insurance, this does however mean that we will collect at the time of service, as Delta Dental requires the patient to pay the provider. We, as a courtesy, bill them for you. When they receive the claim we send, they will then send you a reimbursement check with their rates for the procedures billed within 14-days of treatment. Please keep in mind, that we cannot provide what their rates are, as those are not numbers they disclose to us.
After your new patient appointment, we make sure to create a treatment plan that goes over all your payment options, making decision-making simple!
However, please keep in mind:
1) If your Delta Dental policy you purchased/signed up for has a “missing tooth clause”, please let us know.
2)If your Delta Dental policy you purchased/signed up for has “downgrades” of services or “limitations or frequency limitations on crown of filing procedures” also let us know.
^ These are two things our office will not be able to guarantee we will know when working with your insurance, as Delta Dental does not always provide this information to us as non-contracted providers.
3) We do not do pre-authorizations for Delta Dental, as they take 6-8 weeks to get it back to us. This delays treatment which can mean the infection has 6-8 weeks to grow and get worse. This can result in additional costs and treatment for the patient, which is not ideal. A pro tip we have though is that you can go to your Delta Dental login portal, and enter the codes listed on the treatment plan we provide, and if they can provide an estimate, wonderful! If you have your Delta Log in, we are happy to have you log in on a tablet at our office and we are happy to help you get more information.
CONTINUE TO READ IF YOU WANT MORE DETAILS ON DELTA DENTAL AND WHY SO MUCH IS CHANGING WITH IT:
In regards to dental insurance, we accept ALL PPO dental insurance plans. We also bill ALL PPO insurances for you as a courtesy. We are however not “contracted” with any insurances, but we still accept and bill all insurances for our patients. This means that regardless if we are in or out of network with your insurance, you may still use your dental insurance at our practice and we are still able to provide an estimate for you. Unlike medical insurance, 95% of the time, the dental insurances still pay around the same for in and out-of-network services. The exception is: Delta Dental. Delta Dental makes things a bit more complicated for a patient whose dental provider is not contracted with them. TO NOTE: WE ARE “NON-CONTRACTED PROVIDERS”. They require the patient to pay for their treatment upfront directly to the provider (us) and then we bill them directly as a courtesy to our patients. Then, about 10-14 days later, they reimburse you the patient with their fee for the procedures.
We have no intention to get a contract with Delta Dental, and we will not do so for ethical reasons. They have failed to raise their contribution to dental offices since the 80s and have forced offices that accept Delta Dental to use low-quality items and materials in order to make a profit. Many dentists who have contracts with Delta have to offset the costs elsewhere, typically by hiring part-time employees without benefits. Or alternatively, sending dental work to the cheapest labs possible, or forcing them to do in-house crowns, which can at times compromise the care the patient receives. Here at Rooted Dental Wellness, we are unwilling to compromise the quality of our work in order to finance shareholders of a super corporation. We are also not willing to compromise the livelihood of our talented and educated staff in order to offset the costs to work with dental insurance that does not pay us back for dental care. For these reasons, we will not be contracting with Delta Dental at any time.
Many of our patients at our previous office in Los Osos, alongside many here at Rooted, have noticed many other dental offices are doing this as well in the area. And we would agree, we have noticed many local dentists also dropping their contracts with Delta. For these reasons, we could like to suggest that if you do choose to work with a dentist that is contracted with Delta Dental, when you call and ask if they are in-network, you also ask if they have any intention of dropping them in the next 6mos-12mos. That way, you do not switch dentists just to find the next one is next on the list to terminate their contract. This has been very frustrating for patients, and we hope these tips help you find the answers to your questions.
Why do we choose to work with all PPO insurances, but not contract with them?: For your dental office to be an in-network provider with dental insurance, the practicing dentist must agree to provide services at a discounted rate to all patients. With some insurances, these “discounts” have turned into the dentist losing money to continue to see the patient with certain insurances. For example, some insurances only pay the office 1/3 of what a crown would normally cost. In some cases, the doctor will spend more paying staff and the laboratory fees than what the dental insurance reimburses our office, leaving the dentist “in the hole”. Eventually, this forces the dentist to have to “cut corners” in order to offset the expense. There are many dental insurances that also downgrade services for the patient, which is never in the best interest of the patient. This downgrading of treatment is often the most frustrating part for dentists like Dr. Tinoco practicing the gold standard of care. In this case, it benefits the insurance company because they get to pay the least amount possible, but the patient gets the short end of the stick with a sub-par dental material that may not have longevity. This is why we are no longer in-network with the insurance companies that mandate we compromise a patient’s care.
Not only is optimal care a concern for Dr. Tinoco working with some insurances because he uses top-of-the-line materials and reputable local dental laboratories, but there is a practical side as well: the financial side of operating a business. People believe dentists make a lot of money, forgetting the operating costs of practicing in addition to your dentist’s dental school loans that nowadays range anywhere from 200-500k. The average dental practice in California has an overhead of about 70-80%. For full transparency, our overhead is around 82% because we use top of the line quality materials, locally owned laboratories, and we choose to invest in the best equipment and technology available. Many dental offices hire part-time employees to avoid paying benefits, which allows them to offset the costs of insurance companies that the practice loses money accepting. However, we will never compromise our employee’s livelihood and health for an insurance company’s sake. This means we provide our employees with great benefit packages and yearly staff retreats. For these reasons, it is not in the best interest of the practice as well as our patients to work with many dental insurance companies on the market.