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If you have insurance we all have all wondered why our insurance either doesn't cover something at all or just doesn't seem to cover enough. We recieved a flyer in the mail from the American Dental Association, and I wanted to pass along some interesting news.  

Your dental coverage is not based on what you need or what your dentist recommends. It is based on how much you or your employer pays into the plan. 

How Dental Plans Work: Almost all dental plans are a contract between yourself or your employer and the insurance company. Often, you may have a dental care need that is not covered by your plan. Employers generall choose the cover some, but not all of employee's dental costs. If you are not satisfied with the coverage provided by your insurance, let your employer know. 

The Role of Your Dental Office:  Your dentist's main goal is to help you take good care of your teeth. Many offices will file claims with your dental plan as a service to you. The part of the bill not covered by insurance is your responsibility.

Cost Control Measure used by Dental Benefit Plans:  

               UCR (Usual, Customary & Reasonable) Charges: UCR charges are the maximum allowable amounts that will be covered by the                 plan. Although these terms make it sound like a UCR charge is the standard rate for dental care, it is not. The terms "usual,                 costumary & reasonable" are misleading for several reasons:

                    Insurance companies can set whatever amount they want for UCR charges.  They may not match current actual fees charged                         by dentists in a given area.

                     A company's UCR amounts may stay the same for many years. They do not have to keep up with inflation or the costs of dental                     care.

                    Insurance companies are not required to say how they set their UCR rates. Each company has its own formula.        

            If your dental bill is higher than the UCR, it does not mean your dentist has charged too much. It could mean your insurance             company has not updated its UCR charges. It could also mean that the data used to set the UCR is taken from areas of your state             that are different from yours. 

            Annual Maximums:  This is the largest dollar amount a dental plan will pay during the year. You or your employer decides the                 maximum levels of the payment in its contract with the insurance company. You are expected to pay copayments and any                       costs above the annual maximum. Annual maximums are not always updated to keep up with the costs of dental care. If the annual               maximum of your plan is too low to meet your needs, ask your employer to look into plans with higher annual amounts. 

            Preferred Providers: The plan may want you to choose dental care from its network of preferred providers. The term "preferred"             means these dentists have a contract with the dental benefit plan; it does NOT mean these are dentists the patient prefers. If you get             dental care from a dentist who is not in the network, you may have higher out-of-pocket costs. Learn about your plan's costs when             using both in-and out-of-network dentists.

            Pre-Existing Conditions: A dental plan may not cover conditions that existed before you enrolled in the plan. For example, benefits             will not be paid for replacing a tooth that was missing before the effective date of coverage. Even though your plan may not cover               certain conditions, you may still need treatment to keep your mouth healthy. 

            Coordination of Benefits (COB) or Nonduplication of Benefits:  These terms apply to patients covered by more than one dental             plan. The benefit payments from all insurers should not add up to more than the total charges. Even though you may have two or               more dental benefit plans, there is no guarantee that all of the plans will pay for your services. Sometimes, non of the plans               will pay for the services you need. Each insurance company handles COB in its own way. Please check your plans for details. 

           Plan Frequency Limitations: A dental plan may limit the number of times it will pay for a certain treatment. But some patients may                  need a treatment more often to maintain good oral health. For example, a plan might pay for teeth cleaning only twice a year even                though the patient needs a cleaning four times a year.  Make treatment decisions based on what's best for your health, not just               what is covered by your plan. 

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September 04, 2014
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We have recieved numerous phone calls asking if we see children, young adults or seniors in our practice. YES! Yes is the answer. We are a family orientated practice, we have patients that start coming here and are under 1 year of age, sitting on Mom or Dad's lap and taking a ride in the chair. Then we have some of our patients that happen to be great grand parents, and patients of all ages in between. In this radio show Dr Szafarek talks about the attributes of being able to treat the entire family, and being able to get more pieces of the puzzle for each individual.  Great information to think about! 

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Communication is the heart of our practice. Communication is simply said but much more difficult to really accomplish. It takes years of practice to learn to listen enough to be able to ask the appropriate questions. As one of your health care practitioners it is important to have the doors of communication open to help relieve stress levels, to reduce anxiety, and to really help each and every patient accomplish thier end goals with regard to each patients oral health.  Please take a listen to Dr Szafarek's latest talk show to learn steps that we take to help make this happen for all of our patients.

http://www.szafarekdental.com/radio-shows.html

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Dr Szafarek will be on WILI AM Wayne Norman radio show starting at 7:20 on March 3! 

This show is named "Value Orientated Dentistry-The Patient's Persepective."

As we all know there are more and more Corporate Conglomerate Dentist offices popping up all around us, supposedly for convenience and for savings.  Dr Szafarek wants to talk about this idea, and the real differences that arise between a conglomerate run office and an Individually owned and operated office.  A lot of people don't think about how these differences may affect them long term, at their daily appointments, and even in emergency situations.

Please take a listen this Monday. 

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Baby's First Teeth - Your child's baby teeth help your child chew and speak normally. They also hold space in the jaws for the adult teeth that come in later. Starting infants with good oral care can help protect their teeth for decades to come. A baby's teeth start to come in (erupt) when the baby is about six months old. By age three, most children have a full set of 20 primary teeth. Baby teeth will later be lost (shed) as your child develops and grows. This makes space for adult (permanent) teeth, which begin to come in around age 6. By the age of 21, a person usually has all of their adult teeth.  The chart below tells the names of the baby (primary) teeth. It also shows when each tooth usally erupts and is shed. However, not all children get the same teeth at the same times. Your child's teeth may erupt earlie or later than shown here.

                               

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