Navigate Dental Insurance in Raleigh NC

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How Dental Insurance Works at Our Raleigh NC Clinic

Dental insurance can feel overwhelming with all its technical terms, but we’re here to simplify it. From coverage verification to claim submission, here’s a quick look at how our process works to maximize your benefits and minimize out-of-pocket costs.

1. Coverage Verification
   Before your visit, our team verifies your insurance coverage and reviews the details of your plan. This step helps us inform you of any costs upfront, so there are no surprises when it comes time to pay.
2. Treatment Planning
   Our benefit coordinator works closely with you to map out the best treatment plan for your needs while helping you maximize your dental insurance benefits. We aim to provide options that fit your budget without compromising quality care.
3. Claim Submission
   Once your treatment is complete, we take care of filing the claim with your insurance provider. This way, you don’t have to worry about the paperwork – we handle it all for you.
4. Payment Processing
   After your insurance provider processes the claim, we’ll communicate any remaining balance so you know exactly what to expect. We’re here to offer flexible payment options for any out-of-pocket expenses to make dental care stress-free.

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Understanding PPO Dental Plans

If you’re considering different types of dental insurance, it’s important to understand the basics of PPO (Preferred Provider Organization) and HMO (Health Maintenance Organization) plans. Let’s break down the main differences to help you decide which might work best for your needs.

PPO Dental Plans
PPO dental plans are among the most popular choices. With a PPO, you can choose from a network of participating dentists who offer reduced fees. These plans often cover:

• Preventative Care – Up to 100% for services like cleanings and exams
• Basic Treatments – Typically covers 80% for fillings, extractions, etc.
• Major Treatments – Covers around 50% for crowns, bridges, and similar procedures

PPO plans typically include an annual maximum benefit, generally ranging from $1,000 to $2,000.

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Frequently Asked Questions About Dental Insurance

Have questions about dental insurance? Here are some of the most common questions we receive:

• What’s the difference between a PPO and HMO plan?
  A PPO plan allows flexibility with out-of-network options and covers a percentage of services, whereas an HMO typically requires you to stick to an in-network provider with a pre-arranged fee structure.
• What is a covered benefit?
  A covered benefit is any treatment your insurance plan agrees to pay for, either in full or partially. Each plan is unique, so coverage for specific treatments varies.
• What is optional treatment?
  Optional treatments are dental services that may not be covered by insurance or may exceed your plan’s coverage limit, such as cosmetic procedures. We’ll discuss all options to help you make an informed decision.

If you have additional questions or would like to discuss your specific plan, please contact us at (919) 615-2885. We’re here to help you navigate your dental insurance with confidence.

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Let’s Make the Most of Your Dental Insurance

Policy exemptions or limitations may apply to your insurance company. Our office can assist you in the verification of benefits, so you can plan accordingly.

Dr. Shashank Gattumeedhi will be more than happy to help you decide which treatment options are best for you keeping in mind your insurance coverage. We will also give you other options as well so you can make an informed decision to fit your oral needs keeping finances in mind.

Simply bring your card or claim to our office. We'll be happy to tell you what your insurance will cover and once treatment is done, we will file your claim on your behalf.