April is Oral Cancer Awareness Month

Do you know that oral cancer kills one American every hour of everyday? Are you at risk?

Please take the time to educate yourself on the risk factors for oral cancer. Mountain Vista Dental is committed to screening every patient to help discover this disease at the earliest stages; when it is most treatable. Please let us know if you have any questions or concerns about this disease.

Visit the Oral Cancer Foundation for more information. www.oralcancerfoundation.org

Why Doesn’t My Insurance Pay for This?

Having dental insurance or a dental benefit plan can make it easier to get the dental care you need.  But most dental benefit plans d not cover all dental procedures.   Your dental coverage is not based on what you need or what your dentist recommends,  It is based on how much your employer pays into the plan.

When deciding on treatment, dental benefits should not be the only thing you consider.  Your treatment should be determined by you and your dentist.

HOW DENTAL PLANS WORK

Almost all dental plans are a contract between your employer and an insurance company.  Your employer and the insurer agree on the amount your plan pays and what procedures are covered.  Often, you may have a dental care need that is not covered by your plan.  Employers generally choose to cover some, but not all, of employees’ dental costs.  If you are not satisfied with the coverage provided by your insurance, let your employer know.

THE ROLE OF YOUR DENTAL OFFICE

Your dentist’s main goal is to help you take good care of your teeth.  Many offices will file claims with your dental plan as a service to you.  The part of the bill not covered by insurance is your responsiblity.

COST-CONTROL MEASURES USED BY DENTAL BENEFIT PLANS

Key terms used to describe the features of a dental plan may include the following:

  • UCR (USUAL, CUSTOMARY, AND REASONABLE) CHARGES—–UCR charges are the maximum allowable amounts that will be covered by the plan.  Although these terms make it sound like a UCR charge is the standard rate for dental care, it is not.  The terms “usual,” “customary,” and “reasonable” are misleading for several reasons:
  1. If your dental bill is higher than the UCR, it does not mean your dentist  has charged too much.  It could mean your insurance company has not updated its UCR charges.  It could also mean that the data used to set the UCR is taken from areas of your state that are different from yours.
  2. Insurance companies are not required to say how they set their UCR rates.  Each company has its own formula.
  3. A company’s UCR amounts may stay the same for many years.  They do not have to keep up with inflation or the costs of dental care.
  4. Insurance companies an set whatever amount they want for UCR charges.  They may not match current actual fees charged by dentists in a given area.
  5. ANNUAL MAXIMUMS——–This is the largest dollar amount a dental plan will pay during the year.  Your employer decides the maximum levels of payment in it’s contract with the insurance company.  You are expected to pay copayments and any costs above the annual maximum.  Annual maximums are not always updated to keep up with the cost of dental care.  If the annual maximum of your plan is too low to meet your needs, ask your employer to look into plans with higher annual maximums.
  6. PREFERRED PROVIDERS——The plan may want you to choose dental care from its network of preferred providers.  The term “preferred” means these dentist have a contract with the dental benefit plan; it does not mean these are dentists the patient prefers.  If you get dental care from a dentist who is not in the network, you may have higher out-of -pocket costs.  Learn about your plan’s costs when using both in- and out-of-network dentists.
  7. PRE-EXISTING CONDITIONS——A dental plan may not cover conditions that existed before you enrolled in the plan.  For example, benefits will not be paid for replacing a tooth that was missing before the effective date of coverage.  Even though your plan may not cover certain conditions, you may still need treatment to keep your mouth healthy.
  8. COORDINATION OF BENEFITS (COB) OR NONDUPLICATION OF BENEFITS——These terms apply to patients covered by more than one dental plan.  The benefit payments from all insurers should not add up to more than the totl charges.  Even though you may have two or more dental benefit plans, there is no guarantee that all of the plans will pay for your services.  Sometimes, none of the plans will pay for the services you need.  Each insurance company handles COB in its own way.  Please check your plan details.
  9. PLAN FREQUENCY LIMITATIONS——-A dental plan may limit the number of times it will pay for a certain treatment.  But some patients may need a treatment more often to maintain good oral health.  For example, a plan might pay for teeth cleaning only twice a year even though the patient needs a cleaning 4 times a year.  Make treatment decisions based on what’s best for your health, not just what is covered by your plan.
  10. NOT DENTALLY NECESSARY—–Many dental plans state that only procedures that are medically or dentally necessary will be covered.  If the claim is denied, it does not mean that the services were not necessary.  Treatment decisions should be made by you and your dentist.  If your plan rejects a claim because a service was “not dentally necessary,” you can appeal.  Work with your benefits manager and the plan’s customer service department to appeal the decision in writing.
  • OTHER COST-CONTROL MEASURES—–1.  Bundling–Claims bundling is when two different dental procedures are combined by the insurance company into one procedure.  This may reduce your benefit.  2.  Downcoding—is when a dental plan changes the procedure code to a less complex or lower cost procedure than was reported by the dentist office.  3.  Least expensive alternative treatment—Your plan may have a LEAT clause.  That means that if there is more than one way to treat a condition, the plan will pay for the least expensive treatment.  However, the least expensive option is not always the best.  For example, your dentist may recommend an implant for you, but the plan may only cover less costly dentures.  You should talk with your dentist about the best treatment option for you.

MAKE YOUR DENTAL HEALTH THE TOP PRIORITY

Although you may be tempted to make decisions about your dental care based on what insurance will pay, remember that your health is the most important thing.  Dental insurance is one part of your healthy mouth plan.  If you find out what your dental plan covers and plan accordingly, it can help you have a healthy mouth.  Work with your dentist to take the best possible care of your teeth so they will last a lifetime!

 

 

Adult Fluoride Treatments

 

For many years the standard for preventive dentistry recommended fluoride treatments for all children twice a year until the age of 14. As well as fluoride in the local water supplies.  This therapeutic treatment of topically applied fluoride was shown to dramatically prevent tooth decay.  Newer studies have shown that the benefits of fluoride are not limited to children however. Armed with the latest standard of care education we now provide adults with a fluoride treatment specially formulated for adult teeth.

 Benifits of Adult Fluoride Therapy

  • Reduces dental decay caused by dry mouth associated with most medications including those for blood pressure
  • Extends the lifespan of crowns, bridges, and fillings by strengthening the junction between the restoration and the natural tooth
  • Reduces the risk of root decay where there are receded gums
  • Helps maintain the integrity of older dental work by preventing “recurrent” decay
  • Persons having been treated for gum disease or having had gingival surgery
  • Strengthens enamel compromised by grinding or from acid reflux
  • Strengthens demineralized enamel caused by drinking acidic soft drinks, sport beverages, etc.
  • Any individual having undergone chemotherapy or radiation treatments should receive fluoride therapy
  • Lessens the decay risk of those suffering from “dry mouth” – Sjogren’s Syndrome
  • Saves money – the cost of fluoride is less than most dental plan co-pays for fillings, etc.

While a few insurance plans cover this treatment completely we have negotiated a reduced fee on your behalf.  We believe this treatment is an important and ultimately cost saving benefit for our patients.

Fee: $25.00

 

Sources: http://jada.ada.org/content/138/3/420.full

 

Mother’s Day Giveaway

In honor of Mother’s day Mountain Vista Dental is offering a set of free teeth whitening trays and four tubes of bleach to the most deserving mother. If you know of a mother whose smile has lit up your world we want to know why she deserves a little pampering. Please like/share our facebook page and write us on why your mom is the best. Our office staff will be voting all the way up May 10th and posting the winner on Monday May 13th 2013. We look forward to making one smile a little brighter this Mother’s Day. And thank you mom for everything you do!

 

https://www.facebook.com/pages/Mountain-Vista-Dental/542679349076385?ref=hl

Dental Assistant Recognition Week March 3-9th 2013

Dental offices through out the world are celebrating dental assistants this week in honor of Dental Assistant Recognition Week. This year we say a very big thank you to Neyda, Kris, Amanda and Stacie for all that you do to make our office run as smooth and well as it does! You guys are the best! For more information on this great week of gratitude for our hardworking assistants please check out this link to the American Dental Associations’s article on Dental Assistant Recognition Week.   http://www.ada.org/news/8274.aspx