How PPO Insurance Plans Work at Our Office
Most PPO plans have a contracted dollar fee associated with services provided in our office which means lower out of pockets for our patients. Many plans have an annualized maximum dollar cap (for example $2000 total dollars annually). In addition, many plans cover specific procedures like root canals or crowns at a specific percentage of the contracted fee (for example 80% or 50% of a contracted fee.) As a courtesy, our admin team will coordinate with your insurance carrier and general dentist to provide you with an as accurate as possible pre-treatment estimate prior to starting any treatment in our office. Your consultation, radiographs, and 3-D scan each have specific dental codes that will be considered covered/not covered by your insurance provider. Factors like outstanding claims with another provider or lapses in coverage may not always be captured in our pre-treatment estimate; and you will be responsible for any dollar amount that is not deemed “covered” by your insurance plan. We strongly encourage you to verify coverage with your employer and insurance carrier upon review of our pre-treatment estimate and if you have any concerns about your out of pocket expenses to contact them directly. In the event that we estimate any fees will not be covered or your annual maximum dollar amount will be exceeded, those “out of pocket” fees must be paid in full prior to receiving treatment in our office.
Colorado Medicaid Coverage
We accept Medicaid coverage for eligible children and adults in the state of Colorado. We do not participate in CHP+ or medicare plans. Colorado Dental Medicaid coverage is among the best in the country and we take pride in serving our medicaid patients however there are instances where your annual cap may have been reached and similar to our PPO plans we will coordinate with your general dentist and Dentaquest to provide you with a pre-treatment estimate for services provided in our office. In some cases there will be an “out of pocket” fee that must be paid in full prior to receiving treatment in our office. If you have questions about your coverage we recommend you contact Healthfirst Colorado directly for which information can be located on their website linked below.
Major Carriers we are contracted with:
Delta Dental (Premier)
Careington Network
GEHA
Guardian
United Healthcare
TeamCare
Colorado Medicaid (Healthfirst Colorado)
Plan dependent:
Cigna
Blue Cross Blue Shield
**Please contact us with your insurance information and we will contact the carrier to determine your benefits with our office.
Out-of-Network and HMO Policy
We accept most PPO plans and Colorado Medicaid. We do not accept HMO plans. If you’re unsure how your plan works and if you are in or out-of-network, we’ll verify everything before your visit. Even if you are considered out-of-network, we will work with your out-of-work benefits to determine a pre-treatment estimate.