As of 10-1-2023 and for the planned 2024 year, we are In-Network with GEHA and all Connection Dental Network Affiliates. These Affiliates may include certain Cigna plans, and in the upcoming months we are told the possibility of Aetna, Metlife, Principal, Guardian and several smaller insurance company plans.
Insurance reimbursements have not kept up with general cost increases over the last 10+ years. As a result, we have made the decision to opt out. Many insurance companies still provide out-of-network benefits. To help you make a better-informed decision about continuing getting your dental services with City Dental DC and for more transparency, we are creating a Treatment Plan for every patient. Once we have gotten the basic information from your insurance carrier, we will use that to produce an Estimated Cost for your needed treatment. Here are some FAQ’s.
Q: How do dental benefit plans work?
A: Dental benefit plans are not designed to cover all dental procedures. Instead, think of dental insurance as a “coupon” or “discount” to help cover the costs.
Q: What is a Health Savings Account-HSA / Flex Spending Account-FSA?
A: These are pre-tax accounts to be used towards services not covered by your dental plans, provided by your employer.
Q: What is covered by my plan?
A: Your employer and the plan provider agree on the amount your plan pays and what procedures are covered. Employers generally choose to cover some, but not all of your dental costs. We only recommend the treatment you need.
Q: Who files the claim after my services have been completed
A: We still will file ALL claims for ALL insurance carriers, as a courtesy, to make sure they have the information to process your claim properly.
Q: How will I know what I must pay at my next cleaning / dental appointment?
A: We have contacted your insurance company and have gotten as much information as we can. This means the final amount you will owe for services rendered will only be determined once we get the Explanation of Benefits back from your insurance company.
Q: How can I investigate this myself?
A: When asked, we will give you a treatment plan, which has all the codes for your upcoming appointment. You can give them these “D-codes” and listen to your representative’s answer.
Q: Why is Delta Dental the only Insurance company requiring payment in-full, up-front?
A: This is a requirement stipulated by Delta Dental.
Q: My insurance wants more information
A: Many times, this is a tactic by your carrier to slow down the reimbursement process. We always send everything time stamped and proof of attachments.
Q: My insurance has denied the claim.
A: We continue to be your advocate. Your insurance will have policies in place that we are unaware of. This is why we ask you to go over the treatment plan with your insurance carrier prior to commencing your dental services. We want to be transparent throughout, as to what services you need and how to best provide those services for you.
