Financial & Insurance

As you are aware, the health care industry has undergone, and continues to undergo, numerous changes. The dental industry is also not immune to a number of these changes as well. With change brings confusion, and as a result, our office has received a number of questions regarding dental insurance and related matters. Below please find several of the most common questions we have received, and our thoughts, which we hope help explain and clarify this subject matter. As always, if you have any questions regarding your specific dental insurance plan, we recommend you talk with your insurance representative.

Who determines the benefits and how does it relate to “usual, customary, or reasonable”?

Your dental insurance company may reimburse you, directly, or reimburse this office for the dental services you received. However, for these dental services, sometimes your dental insurance company will reimburse you at a rate lower than your actual dental bill.

Oftentimes, the explanation given by your dental insurance company is that the reimbursement was reduced because your dentist’s fees “exceeded the usual, customary, or reasonable fee” (UCR). This may give you, our patient, the impression that any fee which is greater than the amount paid by the dental insurance company is unreasonable or more than what most dentists in the Bloomington-Normal area charge for these same dental services. This impression would be misleading, and is simply not true.

It is important to note that insurance companies establish their own schedules of fees that they consider allowable. Based upon this information, each insurance company determines its own allowable UCR fees.

Therefore, it may appear that the insurance company may be implying that the dentist is “overcharging” rather than informing you that they are “underpaying” or that their benefits are low. In general, the less expensive insurance policy will use a lower UCR figure.

Is Price your only concern when choosing your dentist?

The fees of the office of Dennis R. Krug, D.D.S. (Cottage Dental Care, LLC) are established based upon a number of factors. Most importantly, they are based upon the skills, abilities, and experience of the dentist as well as the dental hygienists, dental assistant, and the quality of dental services provided. The quality of dental services is also based upon the high quality of products and materials, the latest dental techniques and equipment, and the reputable laboratories used by our office. We provide our patients professional and quality dental services at cost-effective and competitive prices.

Clinical

Are Periodontal Bacteria Destroying Your Gums?

Consider your gums as a living foundation for your teeth. So important is this foundation that, without healthy gum structure, your teeth will become unstable and at-risk for tooth loss.

The Cause of Gum Disease

Periodontal disease is the leading cause of adult tooth loss in the United States. Periodontal disease is formed when harmful bacteria are lodged beneath the gum line, creating pockets or gaps between your gums and teeth. These pockets become infected and over time can destroy bone, teeth, and gum foundation. Smoking, genetics, pregnancy, stress and nutrition have all been found to be factors in the cause of gum disease.

The Diagnosis of Gum Disease

If you have been diagnosed with gum disease, there is hope. There are treatments that can help reduce further damage to your gums and teeth. Your dentist or periodontist can provide several treatments to reduce infection-causing bacteria and halt further spreading, and diminish the size of periodontal pockets that encourage growth of bacteria.

Treating Gum Disease

The approved method for treating periodontal disease is a procedure known as SRP. SRP is a non-surgical procedure where scaling removes plaque and tartar from the teeth. Root planing then smoothes away the rough areas at the root of the tooth – eliminating bacteria build up. Your dentist may also use approved oral solutions to stop harmful enzymes that cause tooth and gum decay.

Importance of Treatment Now

Treatment of gum disease has become ever more important to your body’s health. Links have been found between periodontal disease and the increased risk of heart disease. Studies have also shown that prolonged gum disease may elevate your risk of stroke and pre-diabetes characteristics (higher than normal blood glucose levels leading to type II diabetes).