Insurance Plans We Accept
Maximizing Your Dental Insurance Benefits
At Irmo Dentistry, Dr. Davis and our experienced team work diligently to help you maximize your dental insurance benefits while providing exceptional care to patients throughout Irmo and surrounding South Carolina communities. We accept most major dental insurance plans and are committed to making your dental care as affordable as possible by understanding your coverage details and coordinating benefits effectively. Our knowledgeable insurance coordinators stay current with changing insurance policies and work as your advocates to ensure you receive maximum benefits available under your plan.
We understand that navigating dental insurance can be confusing and time-consuming, which is why we handle all aspects of insurance coordination as a service to our patients. From initial benefits verification to claims filing and follow-up, our experienced team manages the administrative details so you can focus on maintaining excellent oral health. We’re committed to transparency in all insurance matters and will always provide clear explanations of your coverage and any out-of-pocket expenses before beginning treatment.
Primary Insurance Companies We Accept
Delta Dental Plans
We accept all Delta Dental plan types:
- Blue Cross/Blue Shield of SC
- Delta Dental-Premier Network
- Most Cigna Plans
- AlwaysCare
- Starmount
- Unum Dental
- United Healthcare plans
- Most Metlife plans
Individual and family Delta Dental plans
Cigna Dental Plans
Comprehensive Cigna coverage acceptance:
- Cigna Dental PPO plans with in-network benefits
- Cigna Total Dental Care managed care plans
- Cigna Dental 1500 and Dental 1000 plans
- Cigna HealthSpring Medicare Advantage dental plans
Employer group and individual Cigna plans
Aetna Dental Insurance
All major Aetna dental plan types:
- Aetna Dental PPO preferred provider plans
- Aetna DMO dental maintenance organization plans
- Aetna Better Health Medicaid dental plans
- Aetna Medicare dental coverage plans
Employer-sponsored Aetna dental benefits
Extended Insurance Network Participation
Guardian and MetLife
- Guardian Dental PPO and DentalGuard plans
- MetLife Dental PPO and MetLife TakeAlong plans
- Guardian DentalGuard Preferred network participation
- MetLife Federal Dental employee benefit plans
- Individual and group Guardian and MetLife coverage
Humana and UnitedHealthcare
- Humana Dental PPO and Humana Dental Loyalty Plus
- UnitedHealthcare Dental PPO and managed care plans
- Humana Medicare Advantage dental benefits
- UnitedHealthcare Medicare dental coverage
- Employer group plans for both carriers
Blue Cross Blue Shield
- BCBS Dental Blue preferred provider plans
- Blue Dental traditional and PPO options
- Federal Employee Program BCBS dental plans
- State-specific BCBS dental coverage plans
- BlueCard out-of-state coverage coordination
Regional and Specialty Plans
- Ameritas Dental PPO and indemnity plans
- Principal Dental coverage and group plans
- Renaissance Dental preferred provider plans
- Assurant DHA dental health alliance plans
- Careington Dental discount and insurance plans
Public Insurance Programs
Medicaid Dental Coverage
- South Carolina Medicaid adult and emergency dental benefits
- Healthy Connections Medicaid managed care dental plans
- Emergency Medicaid dental coverage for urgent care
- Children’s Medicaid comprehensive dental benefits through age 21
Medicare Advantage Plans
- Medicare Part C plans with dental benefits
- Medicare Supplement plans with dental coverage
- Dual-eligible special needs plans (D-SNP)
- Medicare Advantage from major carriers with dental benefits
Federal Employee Programs
- Federal Employees Dental and Vision Insurance Program (FEDVIP)
- TRICARE dental coverage for military families
- Veterans Affairs dental benefits for eligible veterans
- Federal Employee Health Benefits (FEHB) dental plans
Understanding Different Insurance Structures
PPO (Preferred Provider Organization) Plans
- In-network benefits with reduced patient costs
- Out-of-network coverage with higher patient responsibility
- No referral requirements for specialist care
- Annual maximums typically $1,000-$2,500
- Choice of providers with varying benefit levels
Traditional Indemnity Plans
- Fee-for-service coverage with provider choice flexibility
- Usual, customary, and reasonable (UCR) fee schedules
- Deductible and coinsurance structures
- No network restrictions for provider selection
- Annual maximum benefits with percentage coverage
Dental HMO/DMO Plans
- Assigned primary care dentist coordination
- Reduced copayments for covered services
- Referral requirements for specialist treatments
- Network provider limitations for coverage
- Preventive care emphasis with low or no cost
Discount Dental Plans
- Membership-based discount programs
- Reduced fees for participating providers
- No waiting periods or annual maximums
- Immediate benefits upon enrollment
- Alternative to traditional insurance coverage
How We Help Maximize Your Coverage
Pre-Treatment Verification
Our insurance coordinators verify your benefits before treatment:
- Annual maximum remaining for the calendar year
- Deductible status and amounts already met
- Coverage percentages for specific treatment categories
- Waiting periods for major restorative treatments
- Pre-authorization requirements for certain procedures
Dual Insurance Coordination
For patients with multiple dental plans:
- Primary and secondary insurance coordination
- Coordination of benefits (COB) calculations
- Maximum benefit optimization across both plans
- Claim sequencing for optimal reimbursement
- Appeal processes for denied claims
Pre-Treatment Estimates
- Insurance pre-determination for major treatments
- Out-of-pocket cost calculations before treatment
- Alternative treatment options based on coverage
- Payment plan coordination with insurance benefits
- Treatment timing optimization for benefit maximization
Complete Insurance Administration
Claims Filing Service
We file insurance claims as a courtesy:
- Electronic claims submission for faster processing
- Complete documentation with necessary supporting materials
- Accurate coding using current ADA procedural codes
- Prompt submission typically within 48 hours of treatment
- Claim tracking and status monitoring
Claims Follow-Up Process
- Payment tracking and follow-up with insurance companies
- Claim appeals for inappropriately denied services
- Additional documentation submission when requested
- Patient communication about claim status and payments
- Account reconciliation once insurance processes claims
Patient Responsibility
- Clear cost estimates before treatment begins
- Insurance explanation of benefits (EOB) interpretation
- Remaining balance collection after insurance payment
- Payment plan options for amounts not covered by insurance
- Annual benefit tracking to optimize usage
When We're Not In Your Network
Out-of-Network Coverage
Many insurance plans provide benefits even when we’re not contracted:
- Reduced benefit percentages compared to in-network providers
- Higher deductibles may apply to out-of-network services
- Balance billing allowed for amounts above insurance payments
- UCR fee limitations may affect reimbursement levels
- Annual maximums still apply to out-of-network care
Maximizing Out-of-Network Benefits
- Pre-treatment estimates to understand exact coverage
- Alternative treatment timing to optimize benefits
- Flexible payment options for higher out-of-pocket costs
- Quality care justification for choosing our practice
- Appeal assistance for unreasonably low reimbursements
FAQS
How do I know if you accept my specific insurance plan?
Call our office with your insurance information, and we’ll verify your coverage immediately. We accept most major dental insurance plans, but coverage details vary by specific plan type. Our insurance coordinators can confirm your benefits and explain how your coverage works with our practice.
What if my insurance company isn't listed?
We may still be able to work with your insurance company even if it’s not specifically listed. Many smaller or regional insurance companies still provide out-of-network benefits. Contact our office to discuss your specific plan and available options.
Will you file my insurance claims?
Yes, we file insurance claims as a courtesy to our patients. We submit claims electronically for faster processing and follow up on claims to ensure proper payment. We’ll also help with appeals if claims are inappropriately denied.
What if my insurance doesn't cover a recommended treatment?
We’ll explain exactly what your insurance covers and discuss alternative treatment options that may have better coverage. We also offer financing and payment plans to make necessary treatments affordable even when insurance coverage is limited.
How long does insurance reimbursement take?
Most insurance companies process claims within 2-4 weeks of submission. We track all claims and follow up on any delayed payments. Electronic claims typically process faster than paper submissions.
Can you help me understand my dental benefits?
Absolutely. Our insurance coordinators will explain your benefits in clear terms, including deductibles, annual maximums, coverage percentages, and any limitations. We want you to understand exactly how your insurance works and how to maximize your benefits.