Q: Do you take/accept my dental insurance?
We work with all PPO or indemnity insurance plans. We will let you know what your estimated out-of-pocket share is for each visit, and we will let you know about limitations on your policy such as frequency of services, applicable deductibles, and annual maximums. It is important that you keep us apprised of any changes in your dental insurance plan before you come to see us. We may be considered out-of-network providers for some PPO plans, and in-network providers for others. The world of insurance gets more complicated every year, as employers cut their overhead and insurance companies become more restrictive.
Q: What if I have an HMO dental plan?
We welcome you as a patient and you will need to pay 100% out of pocket for all services provided. We are not in-network providers with any dental HMO plan.
Q: For which plans are you a ‘preferred provider’ or an ‘in network provider’?
Both Drs. Koshki & Sakamoto are in-network preferred providers with:
| MetLife PDP Plus | Humana PPO |
| Guardian DentalGuard Preferred PPO | Principal PPO |
| Aetna PPO Extend Network | Sunlife PPO |
| United Concordia Elite Plus PPO | Ameritas PPO |
| Anthem Blue Cross Complete & Grid Plus | Lincoln National PPO |
| Blue Shield of CA PPO | United HeathCare PPO |
| Cigna PPO (not with all plans) | Delta Dental (not for Delta Medicare Advantage or Delta SelectCare which are HMO plans.) |
We offer a high level of care, as acknowledged by these companies, using their input on our fees. If you don’t see your plan listed, please contact our office for more information.
Q: My dental insurance plan detail indicates it will cover most of my dental services at 100% or other percentages. Why do I sometimes get a bill from your office even after I’ve paid my estimated co-pay and my insurance has paid?
Many insurance plans cover a percentage of fees based on a pre-determined ‘Table of Allowances”. These fees have been configured by the insurance company rather than our actual fees. This is a way your employer can control costs and still offer some level of dental insurance coverage. In some cases, our office does not have access to the insurance company’s ‘Table of Allowances’. Also, although we try and get a detailed breakdown of every patient’s insurance plan, there are some internal limitations and downgrades that we are not privy to as providers. We will give you our best estimate for your out-of-pocket share and bill you for any amount remaining after your insurance pays its portion.
Q: If I have double insurance coverage, will all my charges be covered at 100%?
There have been changes in “Coordination of Benefits” policies that your insurance companies may follow, and even though you have double coverage, you may still need to pay out of pocket for some of your treatment charges. We are seeing an ever-increasing amount of “non-duplication of benefits” clauses included in benefit plans, which means that a secondary plan that contains this clause will not pay any additional benefits.
Q: I am either self-employed or my employer does not offer coverage. What dental insurance does your office recommend for me as an individual?
Individual insurance policies are quite expensive or have other limitations, which most patients have found prohibitive. While we cannot recommend any specific plan to you, we will work with you carefully to estimate your dental expenses and continue to provide excellent care with very competitive fees. Please check with an insurance broker to see what plans might be available for you to purchase, keeping in mind that we are not in network with any HMO dental plans, or some PPO plans.
We also offer our own in-office discount member plan called Smile Health Plan. You can find details of the plan right here on our website.
We are also happy to announce that we are now accepting the Aetna Access Discount Dental Program. With this plan, you pay a small annual fee and you will have access to our Aetna PPO fees without the trouble of limitations, downgrades, deductibles, missing tooth clause or other problems associated with insurance plans. Please see more details about Aetna Access Discount plan on our website.
Q: What options for payment for my fees for services do you offer?
We accept all major credit cards, personal checks & cash and we offer CareCredit financing with interest free plans available for those who qualify. Our office will always be available to answer any specific questions you may have regarding your dental insurance coverage. We would like your experience with our office to be comfortable – let us know how we may be of service to you.
Visit Santa Monica Dental Arts Today!
Proud Member of
and
Proud Corporate Partners of the Santa Monica Malibu Education Foundation
