Insurance for your TMD visit.
Insurance coverage for your TMD issues is different than for other dental or orthodontic procedures. Due to the nature of these disorders and the services that we provide, many of our services may be covered under medical insurance. Like most dental offices, our the office is out of network with any medical and dental insurance companies and unfortunately, Dr. Holman is not an HMO (e.g. Kaiser), Medical or Medicare provider, and for all the services we will provide to you, we will submit to your medical and dental insurance companies.
Once you fill out the TMD medical and dental history form we will be able to determine what benefits you may have under your medical and dental insurance for TMD problems. It also allows us to pre-authorize your insurance plan for the diagnostic procedures that may be required in your case. This form is quite comprehensive and can take up to 30-40 minutes to complete. Please answer all the questions and sections. You should plan to fill out the form in one sitting. If you stop in the middle and come back later to finish it, you will time out and have to start all over.
We will help you to submit a claim to your medical insurance company for reimbursement under the benefits available to you with the contract between you and your insurance company. We will attempt to pre-authorize any diagnostic services that are necessary before any specific treatment is rendered. After we make this determination, we will help you to submit all the necessary claims required throughout treatment. To this end, we have taken the extra step to hire a third party specialized Medical Billing Service to provide the best chance of obtaining the maximum available insurance reimbursement of your policy/ policies.
Please understand that no insurance policy will pay 100% of the fees that we charge. Every policy is different, and our Medical Billing Service will be able to obtain the best level of reimbursement available to you under the terms of your specific policy. This is the most that any dental office can do when attempting to use medical insurance to cover medical procedures rendered by a dentist. Please remember that it is still your responsibility to know your coverage and benefits and personally check on them with your insurance company.
Your insurance policy is a contract between you and your insurance company and your insurance company is responsible to you, not to our office. Therefore, your insurance company should reimburse you according to the terms of your contract.
