Integrity Family Dentistry works with patients to find the most cost-effective option for their care, whether that is enrolling them into Integrity’s membership plan, or billing to a patient’s insurance.
With a membership plan, instead of paying for each service separately, you receive services at a reduced fees. The plan provides a 100%, 60% or 20% discount on our office fees. Membership plan discounts last for the length indicated on the plan. They do not auto-renew, and are not a monthly fee.
Working with insurance companies is time-consuming and expensive. With a membership plan, the costs are simple and transparent; they allow us to simplify our business, saving us money, which means we can offer our services to you at a discounted price. With a membership plan, we all win.
Insurances include deductibles and maximums. Savings with only start with insurance after you have paid a certain amount, and are cut off after the insurance company has paid out the maximum on the plan. In contrast, membership plan savings start immediately and continue for the full plan length with no maximum.
Insurance coverage is often unclear. We submit pre-authorizations on treatment to get as close as possible to your out-of-pocket costs. Until we hear back from the insurance company, we estimate what the procedure will cost you based on how they have paid on prior claims at our office. Membership plans eliminate the guessing game. When costs are clear, you are able to make immediate, informed decisions for your health.
When you contract with an insurance, you pay for services you may or may not use. You make monthly payments for potential needs, which you may never experience. In contrast, when you use our membership plan, you receive discounts for dental services, as you need them. We believe you should only pay for what you need.
Patients often ask if we “accept” specific insurance plans. We bill to most insurance companies, but we are not contracted with any of them. This means that patients who choose to bill to their insurance will receive their out-of-network benefits.
If an office is in contract with an insurance company, the insurance company dictates what the office can charge and what the patient will pay. Most services are reimbursed below the operating cost, leaving the office unable to collect the full office fee on services rendered. This is the reason we ended all of our insurance contracts.
Most insurance companies offer out-of-network benefits as a part of their plans, so if you would like to use your insurance, we are happy to be your out-of-network provider. About half of our patients take this route.
It is important to note that insurance companies are not clear about their reimbursement for out-of-network care. Although insurance companies offer patients a percentage breakdown for out-of-network benefits, these percentages are often misleading, since they are based on the insurance company’s “allowed amount” and not the actual cost of care. If an insurance company says they will reimburse 100% of a procedure, this means they will pay 100% of what they want to pay, leaving the remaining unpaid amount for the patient to cover.
Thankfully, insurance companies share these allowed amounts and reimbursement amounts in “pre-authorizations”. We can request these if we can specify exactly which dental services will be rendered and prove that these services are needed. Whenever possible, we request these pre-authorizations before services are rendered. After the request is sent, insurance companies generally take 1-3 weeks to provide the pre-authorization. We then update the patient on what their cost would be, allowing them to make informed decisions on how they would like to move forward. Our aim is to be as transparent as possible with the cost of treatment.
What if your insurance doesn’t offer out-of-network benefits? We are still happy to see you as a cash-paying patient. Our cash-paying patients generally use our membership plans to help offset their costs. Patients also have the option of using our third-party payment plan through Cherry to pay for services at our office.
While we are happy to take payments by card, our processor adds a 3.75% fee to credit card payments. We also partner with Cherry to offer our patients payment plans. Check them out or call our office for more details.
Feel free to call or text our office. We are always happy to help.