At Snoqualmie Valley Kids Dentist, we are committed to providing high-quality care while offering transparency and flexibility in insurance and payment options. Here’s an overview of the different dental plans we work with and how they may impact your treatment costs:
Dental Plan Options
Table of Allowances
Under this plan, the patient pays based on a set allowance for each procedure, as determined by the insurance provider. If the procedure exceeds the allowance, you are responsible for covering the difference. This option allows you the flexibility to choose any dentist without a financial penalty.
Preferred Provider Organizations (PPOs)
In PPO plans, dentists sign contracts to become “in-network” providers. In exchange for being part of the network, dentists must offer discounted rates (usually 20-30%) of their regular fees. The insurance company pays a portion of these discounted fees, but it often appears as 100% coverage, which actually applies only to the reduced fee, not the full fee. If you visit an out-of-network provider, the insurance company may reimburse you at a lower rate, or sometimes not at all, leaving you responsible for the balance.
Health Maintenance Organizations (HMOs)
HMOs require you to use a network of providers to receive coverage. For pediatric dentistry, this often means fewer options and access to specialists may be more limited.
Why We Limit Participation in PPOs
We base our fees on the cost of providing the highest standard of care. Joining additional PPO networks would mean offering discounts to certain insurance providers, which could result in us needing to raise fees for other patients to cover the difference. We believe this is unfair to patients who don’t have access to employer-sponsored insurance or dental plans. We want to keep fees consistent for all our patients to ensure equitable care.
Insurance Benefits and Payment Plans
As a courtesy, we will process your insurance claims in our office, which saves you time and effort. However, since insurance plans can vary widely, and their policies frequently change, you may still be responsible for any portion of the costs that your plan does not cover. We encourage you to reach out to your insurance carrier for the most up-to-date information about your coverage.
Flexible Payment Options
We understand that managing dental care costs can be challenging, so we offer flexible payment options, including Visa, MasterCard, or cash, to help make treatment more affordable for you and your family.
If you have any questions about insurance or payment options, don’t hesitate to ask. We’re here to help you navigate these choices and ensure your child receives the best care possible.