Insurance

Shoreline Smiles accepts all eligible insurance plans. We gladly work with most PPO and Indemnity plans. We have listed the following PPO insurance plans that we carry. If your plan is not on the list, kindly call us to talk about your coverage.

Here at Shoreline Smiles, we try to provide each of our patients with the best treatment plan. If you have no idea what your patient responsibility is, feel free to ask. One situation is if you have insurance. We can file it for you, and we’ll work with your insurance company directly.

You will have the responsibility to pay for your estimated deductible/co-payment at the time you are treated. You will then pay for any remaining balance when your insurance claims are processed.

If you don’t have an insurance plan, you will need to pay the full amount at your appointment. For primary treatments such as dentures, bridges, crowns, and others, you will need to spend at least one half of the treatment at your first appointment. You will settle your balance during the final appointment for your treatment.

Insurance Policy

If we recommend a procedure to be done in our dental opinion, we cannot guarantee your insurance will cover that said procedure or treatment. However, we will be glad to assist you with any insurance question you may have about your coverage.

Frequently Asked Questions

What should you bring to your first visit?

For the first time having an appointment with us, we kindly request you arrive early so we can complete all the necessary paperwork.

What should you do if your insurance changes?

Your insurance claim may not be correctly processed if you overlook even a single change. You may still be under the same insurance company, but your plan number, subscriber number, or group number may have changed. Avoid this situation by being prepared in verifying your insurance with each visit.

Why was your insurance claim denied?

There are several reasons your claim may be denied:

  • Your name is misspelled
  • Your birthdate is incorrect
  • Your Group Number or Subscriber Number is incorrect
  • The Student Status is not yet updated
  • You failed to see a provider within your network
  • Your insurance has ended
  • You have reached your maximum yearly benefit
  • Your insurance only lets you have cleanings twice a year
  • Your treatment is not covered
  • Major Restoration procedures require a waiting period
  • Missing tooth clause

Can insurance companies limit coverage?

Yes. It is therefore essential to contact your medical insurance company right away. Ask them what is to be done for you to receive your full benefits.

Acquiring Dental Insurance

Dental insurance plans are categorized according to premiums or dental procedures. There are major and minor dental premiums. Basic packages cover most minor procedures by about seventy percent, and with you covering the rest.

Most major procedures cover the fifty percent rating, leaving you with monetary responsibility to pay for the balance. There are some insurance companies that shoulder the total cost of minor procedures should their policies allow for it.

Rates will vary from company to company and take note of any administration membership fees. Your choice of payment can be monthly, quarterly, or annually. You may get a discount when you pay yearly. All insurance companies put a limit to the number of procedure you can avail in a year. Be sure to ask your insurance agent regarding this.

For basic dental and preventative exams, which can include x-rays, it may be covered at a hundred percent. Anything else like periodontics, prosthodontics, endodontics, and comprehensive exams may have lower benefits and limited coverage.

What sort of dental coverage is suitable for you?

You can find dental coverage that is tailor-made for what you need. If you have good dental health, don’t have any dental problem, and need coverage for routine cleaning and checkups, a simple dental plan would be enough.

However, if you are prone to dental problems or you plan to get extensive dental work soon, go for an insurance policy that covers a significant percentage of dental treatment costs. Do note that teeth positioning and mouth shape are hereditary; cavities are not.

Dental insurance is helpful to have with you for all your dental expenses. Dental problems or not, dental coverage is necessary. Talk to us for any questions you may have.

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