Understanding how dental insurance works can be challenging, but we’re here to guide you through the process. Apollo Dental works with many insurance providers to ensure our patients have access to high-quality, affordable dental care.
Below are answers to some of the most commonly asked insurance-related questions. If you have additional questions, please contact us.
Do You Accept My Dental Insurance?
In an effort to make dental care accessible for everyone, we accept most major dental insurance plans and many plans from smaller insurance providers. Some of the insurance plans we accept include Delta Dental, HealthPartners, Blue Cross, Cigna, Premier Dental, MetLife and many others. However, just because we accept coverage from specific insurance companies does not necessarily mean we accept your specific plan. It’s important to consult with your insurance company to determine if Apollo Dental is covered by your policy. We also accept a limited number of Medical Assistance patients. Please check with us for availability.
How Do I File an Insurance Claim?
If you have valid dental insurance, we’ll file the claim on your behalf. When you schedule your appointment, we’ll collect your insurance information. At your appointment, we’ll give you an estimate of your patient portion based on the information you provided to us. We’ll submit the claim to your insurance company following your appointment. It typically takes 3 to 6 weeks for insurance companies to respond with payment.
If I Have Insurance, Will I Have to Pay for My Visit?
Your insurance plan may cover all, a portion or none of your visit. We’ll provide you with an estimate of your patient portion at your appointment, and we’ll collect this payment at the time of your appointment. For your convenience, we accept cash, check, debit cards and major credit cards. Depending on your plan and the service you’re receiving, you may owe nothing at the time of your visit.
My Insurance Company Sent Me an Explanation of Benefit. What does this mean?
Most insurance companies send an Explanation of Benefit (EOB) once they have processed your claim. It provides all the details regarding the claim, including what was covered and what you may owe. In some cases, the insurance company may not pay anything based on provisions in your contract. Please note that the EOB is not a bill. If you do owe an outstanding balance, you will receive a bill from us separately. Your insurance company will not bill you.
How Do I Pay My Balance?
After we have receive payment from your insurance company, we’ll provide you with a statement summarizing any remaining balance you’re responsible to pay. In the event your insurance company denies payment, you will be responsible for all charges incurred for your care. You can pay your balance using any of our convenient payment methods, including online payments through our website.
Why Didn’t My Insurance Cover My Care?
It’s important to know and understand your insurance policy. Apollo Dental is not responsible for determining whether or not your care will be covered by insurance. There are many reasons why insurance might not cover your care. This is often dependent on your specific policy and other care you have received. If you have questions regarding why your care wasn’t covered, you will need to contact your insurance company directly.
I Don’t Have Dental Insurance. Can I Still Be a Patient?
Having dental insurance is not a requirement to be a patient at Apollo Dental. Many of our patients do not carry dental insurance. We offer a variety of payment options and payment plans, including Care Packages.
How Do I Handle My Account if I Have More Than One Dental Insurance Policy?
If you have dual dental insurance (more than one active policy), we will help file your claims and handle insurance questions on your behalf. We’ll use the same filing process we would for a patient with a single active policy, and we’ll also file the secondary claim on your behalf after your primary insurance company has paid any applicable benefit. Once both insurance companies have processed your claim, we will provide you with a statement for any remaining balance. In the event your insurance company denies payment for any reason, you will be responsible for all charges incurred for your care.
Dental Insurance Terminology
Deductible
The amount of money that you must pay to your dentist out-of-pocket before your insurance company will pay for any services. This amount is set when purchasing or setting up the plan as a benefit.
Explanation of Benefits (EOB)
This is a document prepared by the dental insurance company and issued to the patients and dentist. It explains how the insurance company has adjudicated the claim that was submitted for services provided to the patient.
Missing Tooth Clause
Protects the insurance company from paying for the replacement of a tooth that was missing before the policy was in effect.
Replacement Clause
Protects the insurance company from paying to replace dentures, partials, bridges, etc., until a specified time limit has passed.
Waiting Period
The length of time an insurance company will make you wait after you are covered before they will pay for certain procedures.
Yearly Maximum
The total amount that your insurance company will pay for any services during the plan year. The yearly maximum renews every year, typically on January 1, but your plan may have set a different date.