Dental Insurance

Callahan Dental is not a direct participant with any dental insurance plan.  We are happy to assist you with the information you need for insurance claims and will submit all the paperwork for all insurance claims for you, using twenty plus years of insurance experience to maximize your benefits.

Please know that we will do everything possible to see that you receive the full benefits of your policy. If for some reason your insurance company has not paid their portion within a reasonable amount of time, you are responsible for your balance. 

Dental insurance is very different from medical insurance. We’ve prepared these frequently asked questions to help ensure you receive the maximum benefit from your plan.

Will my insurance pay for this?
Typically, plans cover a percentage of treatment rather than the full amount (although many will cover 100% of certain services, like twice-a-year dental cleanings). That’s because unlike medical insurance, dental plans are designed to help defray costs – not cover them completely. Your plan may not cover all necessary procedures. The more you and your employer pay for insurance, the higher the covered percentage will be and the more procedures it will cover.
How do I find out what my insurance covers?
Your plan sponsor or human resource department should provide you with a summary of your plan’s co-payments, exclusions, limitations and annual maximums. We will gladly provide estimates for you based on what the average plan pays. Keep in mind that plans vary – often there are even differing levels of coverage within the same company.
Can I get all my dental work done at once?
You can, and we want to provide it for you! However, most plans have annual maximums. Ask your plan sponsor or human resource administrator what your plan’s maximum is and whether your “annual year” is based on the calendar year, your hire date, or another factor. Also find out what “frequency exclusions” your plan includes – for example, a plan that pays for a cleaning every six months will not pay if your cleaning is even 1 day earlier.
What if I wait until next year so my insurance will cover it?
The sooner your care is completed, the less likely the chance of costly and time-consuming complications. We’ve often seen patients pay more out-of-pocket due to delaying treatment than they would have paid had the treatment been performed when recommended – due to their condition worsening as time passes. We offer both payment plans and CareCredit so our patients can avoid delaying care and therefore minimize the risk of complications.
My insurance statement’s Explanation of Benefits (EOB) says my dentist exceeded the “usual, customary, and reasonable” (UCR) fee. Was I overcharged?
No. Insurance carriers set arbitrary reimbursement levels, defining for themselves what is “usual, customary, and reasonable.” The American Dental Association has recently received a favorable federal ruling in two separate class action suits trying to clarify this misleading terminology. You’ll find most dentists in the metropolitan DC area exceed the insurance companies’ definition of UCR.
My insurance says it covers 100% for exams and cleanings -- why didn’t I get 100% reimbursement?
This is a UCR issue (please see preceding question). Your insurance company pays 100% of the arbitrary limit they have set with your employer – this does not reflect what dentists in the metropolitan DC area actually charge.
Why do you ask me to pay for my care at the time of service, since I have insurance?
The costs of providing quality dental care are rising far faster than annual inflation rates. We work to cut administrative costs, minimizing your out-of-pocket expenses, by asking for payment at the time of service for routine care. Since insurance rarely pays 100% for any service, these savings are passed directly to you.
Why can’t I just pay my co-payment?
We don’t know exactly what your co-payment is. Unlike medical insurance, co-payments are not fixed amounts and can vary with each procedure. Each insurance plan has its separate limitations, deductibles, UCRs, exclusions, preexisting conditions, etc. We would have to double our administrative staff – increasing patient costs dramatically – to attempt to determine co-payments ahead of time.
How can my insurance company say they will pay only for the “least expensive alternative treatment”?
The “fine print” of most insurance plans allows them to pay for the least expensive treatment alternative. Your insurance benefits depend on the contract negotiated with your employer. Keep in mind that the least expensive treatment may not be the best and may be the most expensive in the long run.