Integrity Family Dentistry works with patients to find the most cost-effective option for their care, whether that is billing to a patient’s insurance, or enrolling them into Integrity’s membership plan.
Integrity Family Dentistry is out of network with all insurances. Integrity can bill to most insurances, and half of Integrity’s patients use this office to receive their out-of-network benefits. That said, the other half of Integrity’s patients either do not have insurance, or choose not to bill to them, opting instead to save money with Integrity’s membership plan. Whichever path patients choose, Integrity Family Dentistry strives to keep costs transparent.
Membership plans save you money. Instead of paying for each service separately, you receive coverage for a set of services at a reduced fee. The plan also provides a discount for any additional service; you pay for your basic care, and receive further treatment at a discounted price.
We offer the following three membership plans:
Membership plans save us money too. Working with insurance companies is time-consuming and expensive. Sometimes, insurance companies promise a certain reimbursement, and then fail to follow through, paying a smaller amount than advertised. When that happens, we often pay the difference. This hurts our business. With a membership plan, the costs are simple and transparent; they allow us to simplify our business, saving us money, which means we can offer our services to you at a discounted price. With a membership plan, we all win.
Insurances include deductibles and maximums. Savings only start after you have paid a certain amount, and are cut off after the insurance company has paid a certain amount. In contrast, membership plan savings start immediately and continue for as long as you choose to keep the plan.
Insurance coverage is often unclear. In order to find out how much insurance will cover, we need to submit a pre-authorization. Until we hear back from the insurance company, we do not know how much the procedure will cost you, and can only offer you estimates. Membership plans eliminate the guessing game. When costs are clear, you are able to make immediate, informed decisions for your health.
When you buy insurance, you pay for services you may or may not use. You make monthly payments for potential needs, which you may never experience. In contrast, when you buy a membership plan, you receive coverage for a specific set of basic dental services, and you get a discount on any further care, which you would only pay for if you needed it. We believe you should only pay for what you need.
Patients often ask if we “accept” specific insurance plans. We bill to most insurance companies, but we are not contracted with any of them. This means that patients who choose to bill to their insurance will receive their out-of-network benefits.
If an office is in contract with an insurance company, the insurance company dictates what the office can charge and what the patient will pay. Most services are reimbursed below the operating cost, leaving the office unable to collect the full office fee on services rendered. This is the reason we ended all of our insurance contracts.
Most insurance companies offer out-of-network benefits as a part of their plans, so if you would like to use your insurance, we are happy to be your out-of-network provider. About half of our patients take this route.
It is important to note that insurance companies are not clear about their reimbursement for out-of-network care. Although insurance companies offer patients a percentage breakdown for out-of-network benefits, these percentages are often misleading, since they are based on the insurance company’s “allowed amount” and not the actual cost of care. If an insurance company says they will reimburse 100% of a procedure, this means they will pay 100% of what they want to pay, leaving the remaining unpaid amount for the patient to cover.
Thankfully, insurance companies share these allowed amounts and reimbursement amounts in “pre-authorizations”. We can request these if we can specify exactly which dental services will be rendered and prove that these services are needed. Whenever possible, we request these pre-authorizations before services are rendered. After the request is sent, insurance companies generally take 1-3 weeks to provide the pre-authorization. We then update the patient on what their cost would be, allowing them to make informed decisions on how they would like to move forward. Our aim is to be as transparent as possible with the cost of treatment.
What if your insurance doesn’t offer out-of-network benefits? We are still happy to see you as a cash-paying patient. Our cash-paying patients generally use our membership plans to help offset their costs. Patients also have the option of using our third-party payment plan through Cherry to pay for services at our office.