Dental Insurance Archives - Adam Brown Dentistry

Finding an Experienced Dentist in Monroe, North Carolina

Andrae Bergeron2020-07-16T16:55:10+00:00June 17th, 2019|Adam Brown DDS, Dental Crowns, Dental Insurance, Dental Trends, General, Oral Health, Teeth Whitening|

There are fewer things more stressful than finding a new health provider, much less finding an office and staff to trust you and your family’s smile with. Whether you’re searching for the right dentist to advise your oral health regimen, or are simply in the market for a new dentist, Carolina’s Dental Choice wants to equip you with the right knowledge to find an experienced dentist suited for your treatment needs.

Find an Experienced Dentist—Don’t Get Unnecessary Treatments

In need of a second opinion after getting a hefty price estimate for a procedure, you’re not sure you really need? Had a bad experience with a previous dentist and searching for a new practice to rebuild trust with? Waited so long for a dental visit that you’re just ready for a fresh start and motivation? No judgments and no worries! Finding an experienced dentist does not have to be an ordeal.

It is easy to get overwhelmed by your search for the right dentist. From Google searches, Yelp reviews, to scouring websites and seeking out word of mouth recommendations, there are many ways in which we try to find a great dentist. If you’ve moved recently or switched insurance companies, it can also be difficult to move on from a long-time dentist and find another that meets all of your expectations.

Where should you even start? We have laid out the most important considerations in your search for the right experienced dentist.

Question 1: What makes a good dental practice?

You have probably asked yourself this before. What makes a good dentist? Is it a staff of gentle hygienists? A dentist who spends time in the room with the patient? The cheapest treatment options around? Let’s discuss it!

Expectations should be met with every point of contact, including staff

Whether you are making your first call to inquire about services, scheduling an appointment, or entering the practice, the staff should be welcoming to patients. Practices that leave patients in the waiting room without greeting and without respect for patients’ time are red flags that the dental practice does not respect the time of their clients. A friendly, punctual staff ensures that the visit is great from start to finish.

Active listening

Between the hygienists and the dentist, you need a practice that listens to what you say. As the patient, you are the best advocate and knowledge base of your own health, and a good dental practice values that. By listening to your concerns and requests, and acting on what they hear, rather than talking over the patient or not spending and giving the time to the patient to speak their concerns, the patient will collaborate with the dental practice to ensure they are receiving the best treatment options.

Attempts to know the patient

In a larger practice, we do not expect our dentists to know the patient’s entire history, but no patient wants to feel like another file on the shelf. A dentist taking the time to know you can affect the level of care that the patient gets. Whether that’s making friendly conversation or taking a few minutes to read your chart, attempting to know the patient can make all the difference in your dental care.

Question 2: What are the warning signs of a bad dentist?

Fraudulent dentists certainly are not the norm, but more often than you would think, dishonest practices have impacted patients in their long-term trust in dentistry and their own oral health. The wrong dentist is more concerned with his pocketbook rather than the overall health of your mouth, meaning he may recommend and perform unnecessary treatments. Procedures that aren’t necessary can wreak havoc on your mouth and lead to further problems down the road.

Signs of Fraudulent Practice

Urgency without explanation:

If your dentist identifies an issue that is not a dental emergency and tells you a procedure needs to be done immediately, you should start by asking why and for full disclosure on the procedure itself. If you are in a new dentist’s chair for a regular cleaning and suddenly you’re bombarded with procedures of a type you’ve never needed before, or that you did not enter the practice asking for help with, then it may be a red flag. When the dentist is vague on the reasoning for procedures, he may be pressuring you into going forward without understanding all of your options.

If it sounds too good to be true, then it probably is:

Some dentists offer very discounted, or even free cleanings as a way to get patients in the door. Once in the chair, they may either hit you with fees that were never mentioned as part of the deal or as mentioned before, pressure you into procedures with intensity.

Lack of Patient Education:

As we mentioned before, the sign of a great dentist is one who educates patients and ensures that decisions are made collectively between the patient and dentist. It is not good practice when dentists and hygienists are not willing to take time and explain the dental issues and recommended procedures to the patient. Even the act of not showing patients their x-rays can be a red flag. Your dentist should take the time to discuss what is shown in your x-rays, point out any lesions or unhealthy teeth, and talk through the treatment plan with the findings.

Question 3: How does dentistry become susceptible to fraud, and how can I determine if I am part of fraudulent dentistry?

We know that for the majority of dentists out there, it took years of hard work and building trust among their patients to make a successful dental practice. But, as in any profession, there are a small number of professionals out there who turn to taking shortcuts for financial gain. For the medical profession in general, medical diagnoses can be subjective. Because of this, we have a number of suggestions to improve patient advocacy.

Understand how your insurance works with the dental practice.

Beyond having a sense of your general dental coverage, you may not know how the dental practices interact before and after your dental visit. After scheduling your appointment, the staff at the dental practice will reach out to your dental insurance company to find out everything that is covered under your provider. So before you even enter the office, the experienced dentist will know everything that can be billed to you during your dental visit. Unfortunately, this can leave the patient vulnerable to receiving treatments that are more likely to be reimbursed by the insurance company, rather than what’s truly right for the teeth.

For example, a dentist may be choosing between a filling and a root canal for a patient. Taking the path with the root canal and crown is more lucrative for the dental practice. This is because it is common knowledge that root canals are easier to pass through an insurance company than a filling, and by receiving a root canal, you’re automatically approved for a crown. Root canals are easier to pass simply because the dentist can justify the root canal by claiming that the patient was in pain. The problem here is that the dentist may have just been able to perform a filling, which is a cheaper procedure and less invasive for the patient.

Now that there are some ways of identifying fraud, let’s talk about active ways to prevent getting in those situations in the first place.

Choose your dentist based on referrals

Your insurance company may be telling you which dentists to see, but take time to do your own research. Seek out others with the same insurance and ask for a recommendation. Or, if you have a current dentist in the same area but you have switched insurance policies, ask your dentist for a recommendation, or ask for a recommendation from a local dentist society or health professional. Just because the insurance company covers a dentist does not make it a suitable referral. Plus, seeking out opinions from family, friends, and co-workers can give recommendations backed by real experiences.

Consider going family-owned rather than corporate

Chain-dentistry practices drive patients through the door with heavy advertising and discounts, quick cleanings, free exams, and of course, hundreds or thousands of dollars in unnecessary dental work. Corporate dental chains can run on a quota-based model that can sometimes lead to practices working on the side of pushing unnecessary treatments.

Ask for the appointment time

Generally, a new patient appointment should take around an hour and a half. If the office tells you that appointment should only last about a half hour, they may be trying to rush you through what should be a thorough cleaning and appointment, rather than give you the time you deserve as a patient. If you’re an established patient, appointment time can vary, but a cleaning should take at least 45 minutes. If it lasts only 15 minutes, it’s time to start asking questions.

Always check your bill

In a true dental scam, a dentist might inflate claims or bill insurers for procedures that the patient didn’t receive. The best way to avoid this from happening is to ensure communication with your dentist, ask for an estimated price upfront (prior to sitting in the dental chair), and always checking your bill at checkout. According to the National Health Care Anti-Fraud Association, it is estimated that Americans lose about $68 billion dollars each year to healthcare fraud. Don’t be a victim of dental fraud; know the signs and do not be afraid to advocate for yourself as a patient.

Check the market rate for common procedures.

There are common procedures you have had before that you know the price for, but when dental pain strikes, sometimes you are willing to pay anything for it to get fixed. It’s at these times when it is most important to ensure that you are being offered a fair, market-rate price, and not just being offered the most expensive procedure that your insurance may or may not cover.

Seek other opinions.

If you have ever had a major dental procedure, it is likely that you might have sought out another opinion. One dentist may recommend that you need it, while another may not. This is totally normal, and encouraged, especially if you feel that any of the signs above are occurring.

Feel out the culture of the office.

While how you feel as a patient is important, seeing how the experienced dentist treats the staff can also impact the care you receive. The best doctors are attentive to patients and staff. If you have a bad feeling with your interaction from the front desk to the dental chair, how can you trust your oral health to the practice? You should feel safe and welcome at the dentist from the moment you walk in the door.

Find a dental provider who’s right for you and your family

Carolina’s Dental Choice is here to make you feel right at home, whether you’re new to the area or a longtime resident. Give us a call today if you’re in need of a welcoming, friendly face in the dental practice world at 704-289-9519.

Why is Dental Insurance and Dental Health Not Included in Regular Healthcare?

monroe2020-07-16T17:13:58+00:00July 31st, 2017|General|

Though dentistry is a medical practice, and is a very important part of an individual’s bodily health, both the medical system and insurance programs do not see it this way. They actually never have. For some strange reason, anything dental related is considered separate from these institutions. Dental insurance and dental health plans are not typically included in regular healthcare, which ends up leaving patients in a pricy predicament that produces negative results. At Carolina’s Dental Choice, we won’t leave you confused as to what is and is not covered. We are committed to taking care of all our patients, and this begins with understanding that dental health is bodily health.

There are countless tales of woe depicting situations where individuals with mild to severe dental issues are not able to receive the care they need because their healthcare provider simply does not cover dental. These individuals end up having to live with the pain caused by cavities, chipped or dead teeth, or even more complicated issues requiring dental surgery. Dental care is simply not seen as a part of one’s health. This makes absolutely no sense. To say there is no link between a person’s dental health and his or her overall health, is completely untrue. Just ask any dentist. Poor oral health can devastate the rest of the body. So why don’t regular healthcare providers see it this way? Well, it’s a bit complicated and extremely antiquated.

A Strange History

Nowadays, dentists are known to be highly trained professionals who have endured numerous years learning their craft but this has not always been the case. An article in the Atlantic provides a brief history of dentistry. The article states that up until the 1800s, all dental problems were taken care of by local barbers. Sounds a little strange, huh? Imagine popping in for a quick shave only to have your barber explain that he needs to pull a few teeth. The local barber could become a primitive dentist in a pinch, often times even conducting minor surgeries as well. This was this way dental worked for years because surgery and medicine were seen as two completely different practices. A barber could also be a dentist and a surgeon, since these practices were messy and barbaric. Bad teeth were yanked from the mouth. Open wounds were sewn back up without numbing agents. It didn’t really take someone well practiced as it did someone who could handle dealing with lots of blood and screaming. Whereas the practice of medicine was more refined, requiring intelligence and finesse. Deciding what would help a patient cope with pain and injury took time and education. So it makes sense for the separation between dentistry and medicine. At least it makes sense for back then.

But once anesthesia and numbing agents came about, everything changed. Patients could now be put under or numbed, and the practice of surgery and dentistry became more sophisticated. People began to study oral health more seriously, leading to a true profession in the field of dentistry. Even though the idea of dentistry was changing to something proper and professional, the stigma of its previous uncivilized nature was never dropped. Students wishing to pursue studies in dentistry had difficulty

gaining acceptance into medical schools, and they were often left to teach themselves.

The Stigma Continues

Up into the mid 1960s, dentistry was still seen as something not quite connected to our bodily health. It just didn’t carry the same level of importance to society as other medical practices. And when Medicaid was finally established, dental was not included. But that was over fifty years ago, and we know so much more now. It’s clear that oral health is indeed directly connected to our overall health. But for some reason, today’s healthcare providers typically only offer dental for children and pregnant women. The rest of us are on our own. And this is a scary thought seeing how anything beyond a teeth cleaning can end up costing a lot of money. And for those who cannot afford such procedures, they are left to live with the pain. And sadly, this pain usually evolves into more serious issues that cost even more money.

According to The Atlantic, “Just 12 states include the full suite of dental services, including common procedures like crowns and root canals, for Medicaid patients. Three offer nothing at all. The rest provide something in between—usually a list of preventative procedures, like cleanings and X-rays, and sometimes extractions and fillings” (Khazan). And the article goes on to say that when state budgets get tight, guess what gets cut first? Yep, anything to do with dental.

It Just Doesn’t Add Up

Think of the results of poor oral health, bad breath, missing, or discolored teeth can, at the very minimum, reduce confidence. They can even keep you from getting that job you want or impact relationships with friends and loved ones. On a larger scale, poor oral health can effect your very being. Dental problems can cause chronic headaches, diabetes, and heart problems. Nerves that are connected to your mouth can reverberate pain to other parts of your body, resulting in pain all over, not just in the mouth. Yet our healthcare providers continue to see dental issues as completely separate from other bodily health problems. But aren’t our mouths, and everything inside of them, a part of our body? Uh, yeah. How is it logical then that health insurance plans can decide which parts of our body are to be covered? It just doesn’t add up.

It Gets Worse

It’s bad enough that most dental needs are not covered by regular insurance providers, but what’s even worse is that what is covered is incredibly confusing to understand. Usually, the dental procedures included are labeled as “Additional Benefits,” implying they are extra services rather than those that are normally in need by everyone. Healthcare providers also like to explain that they are not required to provide the dental services listed, and that they have the right to discontinue the coverage of any or all of them whenever they want. This means you can go to a dentist one day to have a cavity taken care of, and then come back the very next day for the same procedure only to find out it’s not covered any longer. Healthcare customers are often left in the dark as to which procedures are actually covered. There have been cases of individuals who were covered for a more complicated procedure, such as a root canal, but were not covered for something simple, like a routine cleaning.

What this confusion does, besides cost us more money, is encourage people to not see their dentist regularly. Whereas it is strongly recommended to visit the dentist for a cleaning and checkup every six months, most people only see their local dentist once a year at best. Some just don’t go at all. And this works right into the hands of the healthcare providers. We pay to be insured, they make dental so confusing we don’t end up using it.

Let Us Take Care of You

At Carolina’s Dental Choice we are just as upset about the current state of dental insurance as you. That’s why we are clear and up front about everything. We will not only let you know which insurance companies we accept, but we will also help you understand what procedures are covered. Dental care is a health issue, and we take it very seriously. It’s time to get what you are paying for. Begin to take advantage of your provider’s dental coverage, as big or little as it may be.

By: Andrae Bergeron

CCP Web Design

Content Writer