Members - Q & A

Yes.  By checking with your dentist or our Customer Service representatives, you are assured that your dentist is still participating in the network.  Consult your human resources department or a benefit booklet for more information regarding your specific plan design.

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A participating dentist is a dentist who has signed a participation and membership agreement with DeCare Dental Networks.  The dentist has agreed to accept our allowable charge as payment in full for covered dental care.  A participating dentist is not allowed to bill more than DeCare Dental's allowable charge.  A participating dentist will also file the claim directly with us.  DeCare Dental will make payment directly to the participating dentist and you will receive an explanation of benefits detailing your financial responsibility for any deductible or coinsurance amounts.

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If dental services are received from a non-participating dentist, reimbursement for the services will be paid directly to you, and you are responsible for paying your dentist.  The allowances for services you receive from a non-participating dentist may be significantly less than what DeCare Dental would pay a participating dentist.  You may share more of the cost of your care and are responsible for the dental charges up to the dentist's full-billed amount.  Please note, depending on your benefit package, you may not have any out-of-network benefits.

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Get recommendations from friends, neighbors, coworkers and family subscribers to find a dentist who matches your needs and values.  A convenient location and clinic hours, possibly including Saturday and evening hours, may also be important considerations for you.

Having a dentist whom you visit regularly and feel comfortable with is important to your overall oral health.  Everyone's communication skills differ.  The dentist you select should be someone you can talk to, who will listen to your questions and concerns and who will answer your questions fully.  Here are some questions to ask when selecting a dentist:

• How are after-hour emergencies handled?
• Does the dentist have multi-office locations?
• How long will you have to wait to get an appointment for routine exams and cleanings?  Urgent or same-day care?  Specialty services?
• Is the office staff friendly and helpful?  Do they enjoy working with children?

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• Show your DeCare Dental identification card at the time of each dental visit.
• To assure that you receive full plan benefits, verify that your dentist participates in the DeCare Dental network as indicated on your ID card.
• Discuss treatment options and costs with your dentist to help you select the best course of treatment.
• Ask in advance if all recommended services are necessary and if there are alternatives available.
• Check your explanation of benefits statement to make sure you received the services on this statement.  Although rare, mistakes in billing do occur.
• Finally, make sure you understand your particular benefit plan and are familiar with the specific benefits that it covers.  If you have group coverage, your plan's specific coverage has been determined by your employer.

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Start by asking questions.  Having more information puts you in a better position to make informed decisions.  Depending on your situation, you might consider asking the following questions:

• How much discomfort should I expect?
• Can I expect all my symptoms to go away?  When?
• Will I need to make any changes in my lifestyle?
• What is the cost of the treatment?  What will the cost be to me?
• What alternatives are available?
• How many times have you done this procedure?  How do your results compare with other dentists?
• Will you send a treatment plan to DeCare Dental for an estimate of benefits?  How long will it take to get the pre-estimate back?
• What kind of follow-up care do I need?
• How will I look when the procedure has been completed?
• What could happen if I delay this treatment?
• How can I best care for my mouth after the treatment?

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If you have further questions, please feel free to contact us.