Insurance will reimburse you as the patient directly. Their reimbursement amount will depend on the fees they pay for each service.
Your hygiene visit can range from approximately $120 to $448 depending on many factors. Such as, being due for an exam, being due for x-rays, application of fluoride, and the type of cleaning you are getting.
Your insurance will tell you that you can not be seen here because they like to have their subscribers go to offices that are directly in network with them. But you can indeed still come to see us – you will just pay for your services directly and Delta will reimburse you rather than us.
Your insurance company was not willing to pay benefits at a level where we can continue to provide the care you are used to receiving from us. By changing our relationship with your insurance company we can still utilize your benefits but without the restrictions we currently face as a provider. This allows you to still use the benefits you pay for while allowing us to provide patient care in a way that we feel good about.
The insurance company typically allows 100% as payment for the procedure. It isn’t always 100% of what the dentist may charge. An insurance company may allow $50 as payment for an exam, but the office fee is $80. This leaves $30 that the patient is responsible for. (these are not exact fees – just an example)
This question is usually in response to a patient receiving an EOB (explanation of benefits) from the insurance company. Remember that the amount paid for treatment is the negotiated fee between the insurance carrier and the employer or provider. That amount is applied to the actual fee. Typically, this negotiated fee is much lower than what dentists in your area are charging. It does not mean the dentist is overcharging.