Dentist Roseville

YES! The good news is we will continue to accept your insurance as an unrestricted provider. 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. It is important to understand that you will be responsible for paying the total payment at the time of service or agreeing to one of our financial options, which will be outlined for you below. This includes all regular recall/hygiene 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, usually within 2-3 weeks, to reimburse you directly. Also, it is very important that you confirm the subscriber’s address on file with Delta, as that is where the check will be mailed.

Each employer has a different reimbursement structure for unrestricted providers called a Maximum Allowable Charge 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 fee amount is based on your employer’s choices, not our fee. You are responsible for the difference between your MAC amount and our fee. We are doing everything we can to keep our fees as economical as possible, while continuing to provide you with high quality materials and service. 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 based on your MAC and out of pocket responsibility for you ahead of your appointment, so there should 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.

That is correct. To be clear, Delta Dental is the ONLY insurance company that sends checks to the patient if the provider is unrestricted or non-participating. We are contracted with over 45 other insurance companies and offer an in-house membership discount plan as well! If you have the opportunity to change insurance providers during open enrollment, our team is happy to help you choose a plan that may be more effective at our office. Also, it is helpful to talk to your HR benefits department about the low reimbursement Delta Dental provides to dentists and maybe they can begin offering a second option or change companies.

⦁ Option 1- Pay in full for your treatment at the time of service- This is the most efficient way, and we will file your claim on your behalf. Delta pays patients very quickly, usually within 2-3 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!

⦁ Option 2- After collecting your estimated copay on the day of service, we are happy to securely store your card on file and submit your claim on the day of service. We 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. To be clear, this will be an automatic payment and we will not confirm that the check has been received or deposited before completing the payment.

⦁ Option 3-Set up a payment plan with our office for your treatment. We will bill your credit card weekly or monthly depending on your plan. When you receive your delta check in the mail, deposit it and continue with your payment plan as scheduled. Please note this option is only available for large treatment plans. Anything under $500 will need to do Option 1 or Option 2.

Whichever option you choose, we are here to help make the process as seamless possible.

What we have found:
⦁ Our pre-estimates are extremely accurate through the online portals and you will know fully what your financial responsibility is up front. We will work with you to make a payment plan that matches your budget.

⦁ Delta will send your reimbursement checks faster to you than they typically do to providers. Checks can be tracked online through the Delta Portal. We can also verify if checks have cleared.

⦁ Delta Dental representatives will try to coerce you to go to another dentist because it is in their best interest. You may receive a letter in the mail from Delta saying you no longer can visit our office. They may give you other providers that are in-network and close by. While it is true that your out-of-pocket costs may be less at an in-network provider, we hope that our service and care is valuable enough for you to continue calling Galleria Smile Designs your dental home.