Payments & Financing, Insurance, etc

Integrative Dental Specialists of Long Island participates with all dental PPO insurance programs both in and out of network capacity in order to bring you the highest level of dental care possible without compromise! We handle everything from submitting the insurance forms to helping you recover the most you can from your dental insurance benefits. We will do everything we can to help you afford the dental treatment you need and want.

Financing:
For patients who require major work, a complete treatment payment plan is designed with an appropriate payment schedule. In-House and Third-Party financing available. Give us a call to discuss options to meet your specific meeds.

Accepted Payment Types:
We accept payment in form of check, cash, & financing (see above).

What exactly is dental insurance?

To start off, let’s explain the difference between dental insurance and medical insurance.  One of the biggest differences is that medical insurance (or insurance in general) is there for catastrophic and unavoidable events, such as a car accident, hospitalizations, hurricane damage to your car, a house or an apartment fire, etc. In the case of such an event, insurance companies pay out a lump sum for all of the damages done.  Usually this type of insurance has a large maximum payout ranging from tens to hundreds of thousands of dollars!

Dental Insurance does not quite work this way.  Dental insurance is for smaller unfortunate dental events and routine preventive procedures.  These include things such as hygiene cleanings, scaling and root planings, dental fillings, and maybe one to two large procedures a year, such as root canals and crowns. This type of insurance has a maximum yearly pay out maximum of usually between $1500 and $3000 which is predetermined by your particular dental plan.   Why do dental insurance companies do that? The dental insurers believe that dental procedures (other than preventive and routine procedures) are an avoidable occurrence.  The insurance companies believe if you cracked your tooth on a popcorn kernel, for example, that you should’ve been more careful and that was avoidable. As such, the insurance companies limit the amount of maximum payout to you, the patient. A dental insurance company usually covers only 50% of an avoidable dental event like a root canal. That is the insurance companies rule, NOT the dentist, in or out of network.

What does it mean to be In-Network?

When a dentist applies to be on a dental insurance network, or panel, that dentist has decided to take a reduced negotiated fee for dental services provided from the insurance company. In exchange for a cheaper reimbursement, the dentist is published in your dental provider directory and the insurance’s online directory. Thus, the dentist’s motivation to take a lower fee is to attract more new patients to their practice. A dentist being in network with your dental insurance means that your insurance company will pay the dentist for your dental procedure minus your deductible (up to half) and your co-pay, of course, and only up to the maximum benefit allotted by your particular plan. Sometimes, your insurance company will completely deny a procedure. For example, after you break your tooth on that popcorn kernel, your dentist decides you need a crown, but the insurance company denies the procedure. They decide that an extra large silver filling would be adequate enough to fix your tooth. Why would the insurance company do that? They do that to save themselves the expense of a crown. So why isn’t Dr. Jeffrey Etess and Integrative Dental Specialists of Long Island in your dental insurance network? To explain that, you’ll need to see the other side of the story.  The side the dental insurance companies try to hide from you, the patient.

Each insurance company tells the dentist how much they will pay for each procedure.  So why is this an issue? Insurance companies are about making money for themselves, they do not care about your dental wellness and saving your teeth.  So they encourage dental practitioners to accept these lower fees, to use cheaper materials, to use cheaper dental labs, and see patients much faster to make up the financial difference.  Cheaper labs, cheaper materials, quicker dentistry means lower quality dental care for you, the patient.

What does out of network mean?

Out of network means, we as practitioners, refuse to give in to the demands of the insurance companies to give you the patient, suboptimal care.  Out of network providers have the confidence that patients will come to our practice because we are excellent at dentistry, not because we are on your dental plan. As such, this means the insurance company will reimburse you directly a percentage of the procedure (that the insurance company thinks that fee should be, up to your maximum yearly benefits), leaving you with the excess balance.  Think of it like this, your insurance company says they’ll pay half the cost of your dinner tonight, so you go to The Outback and have yourself a decent steak dinner for $28.  The very next day your insurance company gives you back only $6 towards your $28 meal. You say: “Wait a second, you said you’d pay for half of my dinner!!!! To this, the insurance company says: “Well, we prefer for you to eat at McDonald’s, and you can eat there for only $12.  Outback is not in our network…their prices are too high, so we will give you half of $12, that’s our final answer.” This is the reality of dental insurance, all dental insurance.
Integrative Dental Specialist of Long Island is constantly working with and negotiating with insurance companies to give you the best coverage and benefits, all while not cutting corners.