Our procedure fee tool helps participants of dental plans insured or administered by MetLife understand their out-of-pocket costs. You can search by dentist, procedure code or zip code.
Calculating patients’ out-of-pocket costs is one of the most important tasks a dental front desk team performs. Getting it right builds trust with your patients.
Dental procedures can be expensive. Patients need to understand their costs, including those covered by insurance. If they don’t, the billing process can be messy and frustrating for everyone involved. The best way to avoid this is to learn how to calculate out-of-pocket costs accurately. This will save time, reduce back-and-forth, and help patients feel more confident about their decisions.
Using a dental cost calculator is a great way to help patients compare prices for different procedures and choose the one that works best for them. This tool helps them decide whether to go with an in-network or out-of-network dentist and see how much they can save by going to the dentist of their choice. It also allows them to get an estimate for their out-of-pocket expenses and compare it to what their insurance will pay.
The cost of a procedure can change from month to month and depends on the provider, location, type of service, and other factors. A teeth cleaning, for example, is a relatively inexpensive procedure. But, it’s important to visit the dentist regularly because it can catch problems that might require more invasive and costly treatment in the future.
The annual maximum is the amount of coverage your insurance company will pay for a given year. It’s important to know this number so that you can plan your budget and avoid reaching it.
Dental office front desk staffs rely on dental software to help calculate patients’ out-of-pocket costs, but getting this calculation wrong can cost the clinic both in patient satisfaction and income. It is important to understand the insurance complexities involved in this calculation, so that you can teach your front-desk staff how to properly do it. Otherwise, you can end up charging your patients too little or too much, which will hurt the trust that you have built with them over time.
One of the biggest problems with calculating patients’ out-of-pocket costs is that deductibles and coinsurances can throw a wrench in the process. For example, if a patient needs a filling and their insurance covers 80% of the procedure, the patients will be responsible for the remaining 20%. This is not an uncommon scenario, but it’s important to make sure that your staff is aware of this when calculating patients’ out-of-pocket cost.
Similarly, many insurance policies don’t cover certain procedures, such as teeth whitening or orthodontics. And some procedures are considered medical, not dental, which makes them ineligible for insurance coverage. Regardless of the type of procedure, it’s crucial that patients do their research before choosing a provider, and get a pre-treatment estimate. That way, they can be confident that they are getting the best possible value for their money.
Dental insurance is a common benefit offered by many employers. Its costs vary based on the provider, plan type and coverage level. In addition to monthly premiums, most plans include deductibles, copayments and annual maximums. These limits typically apply to both in- and out-of-network providers. The Ameritas Dental Network offers an in-network cost estimator that allows members to search for typical charges for a specific procedure in their ZIP code and location.
A deductible is a set amount that patients pay for dental care before their insurance begins to pay for covered services. It varies by dental insurance plan type and a patient’s specific deductible amount can change each year. Most dental insurance companies also offer coinsurance, which is a percentage of the total cost that the insurance company will cover after the deductible has been met.
Most dental insurances categorize their plans by metal levels. Higher metal plans have lower deductibles and MOOP limits than lower plans, although the premiums may be higher for the same coverage. Employee-sponsored plans are usually less expensive than individually purchased policies.
When you have an understanding of the complexities of dental insurance, it becomes easier to communicate accurate costs to your patients. Errors in calculations are a common reason patients leave your dental practice, so it’s important to know how to calculate these amounts yourself rather than relying on software.
Providing cost transparency helps dental teams build trust with their patients. When they clearly explain insurance complexities such as deductibles and downgrades, patients are more willing to accept the numbers that are reflected on their billing statement. This will lead to fewer back-and-forth conversations with the front desk and more gratitude from your patients.
To get an estimate of the cost of a procedure, enter the keyword for the type of dental service you are interested in below. You can also enter the name of a dentist to find their dental pricing.
The procedure fee tool provides participants of Delta Dental PPO(tm) and Delta Dental Premier(tm) plans with guidance in understanding the fees that their local dental service providers may charge. The tool is updated daily with actual fees and charges collected by Delta Dental service providers.
The cost calculator gives you the low-to-high estimated treatment charge for a participating Delta Dental general dentist in your ZIP code, as well as the average for non-participating dental service providers in your ZIP code. The calculator is designed to help you understand the fees that your local dental service providers may charge for certain procedures, but it does not guarantee that the provider will accept your Delta Dental PPO or Premier benefits, or that your coverage is available for that procedure.