Delta Dental Insurance
Our mission is to provide each and every one of our patients impeccable dental care with integrity, warmth and enthusiasm. Dr. LaDow built an incredible practice based on these values and it is Dr. Sandretti’s goal to maintain the highest level of quality care utilizing the best materials, highest quality labs and skilled dental professionals. With Dr. LaDow’s imminent retirement, we have been negotiating with Delta Dental to maintain the same fee reimbursements that Dr. LaDow has been receiving for the past many years. Unfortunately, these negotiations were unsuccessful and Delta only offered reimbursements 30-40% less than the fees Dr. LaDow received. Therefore, we made the very difficult decision to become an unrestricted provider with Delta Dental effective October 1, 2022.
We are aware that this is an abrupt change and it was not our intent for this to be a surprise. We have always maintained a high standard of care for our patients and we will not compromise this care or cut corners because of benefit limitations.
We know you have many questions about how this may affect your costs and have put together the following FAQs to help ease any anxieties surrounding this change. As always, our team is here to help answer any questions you may have.
Can I still use my insurance at the dental office?
YES! The good news is we will continue to accept your insurance as an unrestricted provider and this change should have very little effect on your dental care. We will continue to file all dental claims on your behalf and fight for reimbursement if any denials are encountered. The major difference is that ALL insurance reimbursements from Delta Dental will be issued to YOU directly instead of the office. For this reason, we are introducing several new financial options to allow you and your family to receive the dentistry you deserve and desire with little financial stress on your monthly budget.
How will my out-of-pocket expenses change?
Each employer has a different reimbursement structure for unrestricted providers called a maximum allowable contract or MAC. The percentage that is listed on your plan is based on this MAC. For example, if it says 100% coverage, it will be 100% of whatever your MAC amount is based on your employer’s choices, not our fee. You are responsible for the difference between your MAC and our fee. Luckily, most Delta Dental plans allow for on the spot pre-determinations through their online portals. We should be able to determine your estimated insurance reimbursement and out of pocket responsibility for you ahead of your appointment, so there will hopefully be very few surprises. It is our
goal to be as transparent as possible and our team is committed to helping you understand your benefits and guide you through the process of maximizing your coverage for all your dental needs.
So, Delta is going to pay me, the subscriber, and not the office anymore?
That is correct. To be clear, Delta is the ONLY insurance company that does this to unrestricted or non-participating providers. If you have the opportunity to change insurance providers during your open enrollment, our team is happy to help you choose a plan that may be more effective at our office. It is important to understand that you will be responsible for paying the total fee at the time of service or agreeing to one of our many financial options, which will be outlined for you. This includes all regular recall appointments and any treatment you receive with the doctor or hygienist. You need to be on the lookout for a check in the mail from Delta to reimburse you directly. Also, it is very important that you confirm your address on file with Delta, as that is where the check will be mailed.
What are my financial options to pay for my treatment?
1. The most efficient way is to pay in full for your treatment at the time of service and have us file
your claim on your behalf. Delta pays patients very quickly, often within 1-2 weeks, and almost
always before your credit card payment is due. So watch for that check in the mail! Plus, you get
the benefit of earning credit card points with your payment! We will be offering a 5% discount for
patients who choose this option utilizing cash, check or debit card.
2. If option #1 is unrealistic for you and your family, we are happy to securely store your card on
file, collect your estimated copay and file your claim for you on the day of service, and then
charge your card 3 weeks after your appointment for the estimated insurance reimbursement,
allowing you to receive your check in the mail before you are charged.
3. Lastly, we can collect your estimated copay the day of service and you can either bring the check
into the office or mail it to us after endorsing it over to the office and we can deposit the check
on your behalf to cover your balance.
Whatever option you choose, we are here to help make the process as seamless possible.
What we have found:
1. Delta will send your reimbursement checks faster to you than they typically do to providers
2. Delta dental representatives will try to sway you to go to another dentist because it is in their
best interest
3. Delta Dental is the ONLY insurance company that sends checks to the patient if the provider is
non-participating
4. Patients love to pay with their credit cards and earn miles or points and then be reimbursed
promptly with the delta check.
We have many patients that utilize benefits with other insurance companies that choose our practice even though we are non-contracted. Our administrative team is well versed in estimating costs and providing clear financial arrangements that meet your budget. You will continue to receive outstanding dental care from a team that knows you and values you as a patient. As an esteemed patient in our dental practice, we will continue to help you maximize your insurance benefits and will do everything
we can to continue being your dental home.
Our team is constantly working hard to take care of the complete patient and we are always available to answer any questions you may have.
Sincerely,
Dr. Laurie LaDow
Dr. Stephanie Sandretti and Team Smile Designs
