As a dental assistant, you will be working primarily with one or more dentists to perform various procedures on patients. Usually, when patients have a question about their dental insurance coverage, they will be referred to the front desk staff for clarification and explanation. Occasionally, however, you may encounter a question that you can answer on your own. Here’s a simple overview of how dental insurance works.
Most dental insurance companies impose a maximum when it comes to the amount of money they will pay each year per member. As it gets toward the second half of the year, many patients begin to approach this maximum. For example, if a patient’s maximum allowance is $1,000 and $800 has already been paid by the insurance company, then a maximum of $200 is left to apply toward other procedures. If a patient says that he or she is “close to the maximum,” this may mean that certain procedure will need to be put off until the following calendar year, or that the patient will need to speak with the person in charge of financing in your dental office.
Similarly, many companies require a member to pay a deductible, or a certain set dollar amount, prior to any benefits being paid in a particular calendar year. Sometimes this deductible is waived for preventative services, such as x-rays or cleanings. Other times, it’s not. In some dental offices, the front desk staff will include a note as to whether or not a patient’s deductible has already been met. If this is the case in your office, you might be able to let your patient know if it’s been satisfied if he or she asks.
If your patient has a PPO dental plan, the insurance company will generally cover a percentage of each procedure or treatment performed. A common breakdown is that 100 percent of preventative and diagnostic procedures are covered, 80 percent of fillings and root canals, and 50 percent of major restorative procedures like crowns and inlays. Since all insurance companies differ, however, this is definitely not the case for all patients. A question like this usually needs to be referred to the person in the office in charge of billing and insurance queries.
As a dental assistant, it’s great when you’re able to answer your patients’ questions. While having a grasp of the basic idea behind dental insurance coverage is good, it’s usually not a dental assistant’s job to understand the ins and outs of each plan. Knowing some of the terminology used can help you answer some of your patients’ general questions, and it can also allow you to understand what the front desk staff is talking about in discussions about whether a procedure is covered (or not covered).
Jaylyn Miller September 5, 2017
Prior to attending Sunrise School of Dental Assisting I had zero knowledge of the dentistry field and what this career choice would have in store for me. I had an awesome instructor, as well as current Dental Assistants at Sunrise, to help guide me and continue to be successful in my career. Everyone has been extremely helpful and I have had nothing less than a great experience. After graduation, I was hired on by Sunrise and couldn’t be more happy with my job and the decision to attend Sunrise School of Dental Assisting! Thank you all!!
Katie Panchak February 17, 2017
If you’re looking into a promising career as a dental assistant, look no further! I recently graduated from Sunrise School of Dental Assisting and couldn’t be happier with the program! This course provided me with all the knowledge and tools that I needed to become successful in my field. Now I am proud to say that after graduation I have been hired on by Sunrise Dental and LOVE my job! Thanks guys!
Madison McCullock January 12, 2017
Sunrise School of Dental Assisting provided me with the knowledge and skills I needed to begin my career in the Dental field. The instructors were very helpful and thorough in explaining the lessons and procedures to the class, and also made it a point to provide any additional help/tutoring before/after lessons for students. I enjoyed my experience at Sunrise School of Dental Assisting. I would definitely recommend it to anyone looking to receive the proper education necessary in order to excel in their Dental Assisting career
Ashley Hicks June 15, 2016
At Sunrise they give you the tools you need to become successful as a Dental Assistant. You have smaller numbers in the class, so you are able to have more one on one time with an instructor if needed. It is a fast paced class, but the instructor is willing to meet with you before class time if you need help. It is a good balance between lectures and actual lab time. You have great hands on experience and work with live “patients” (class members) in order to get an actual feel of what it would be like. The team at Sunrise Dental are very encouraging and push you to strive for your best. They also help with shadowing at different offices and even inform you if there are job openings at other offices. I would recommend this program to anyone and know that they would also get the great training that I have received!