Insurance World

With you being able to insure just about anything now, you may view dental insurance as a way for greedy companies to take yet more money out of your pockets for something you do not really need.

However, you are wrong. We all know how dentistry costs can mount up – even a routine check up can easily cost you Ј40 - and that is without you actually having any treatments done.

Also, good dental health is not only important for our appearance, it is important for our overall health too as problems in the mouth can often be a sign that something else needs looking at health-wise – even if it just your diet.

A good dental insurance policy can help cover the costs of dental treatment whether it be an emergency or a routine check up, meaning you never have to worry about the cost of keeping your mouth, teeth and gums healthy.

So, who provides dental insurance?

Many healthcare cash plan providers offer cover for dentistry fees – up to a set limit – within their policies. And now there are also a select number of companies who offer standalone dental insurance.

The cover offered by the insurers vary, but depending who take you take a policy out with and whether it is part of a cash plan or a standalone dental insurance policy, you can get cover that will pay for routine treatment, dental emergencies and accidental dental injuries.

Currently one insurer provides cover for serious dental problems such as reconstructive surgery including plastic surgery following a dental injury or oral cancer.

Where to buy

As with all insurances, the key to getting the best cover at a price to suit your budget is by shopping around. The internet has a wealth of dental insurers and policies on offer so you can take your time in comparing the policy terms and conditions – and its benefits – on a like for like basis.

That way you can ensure you get the level of cover you need to keep your mouth – and your overall health and appearance – healthy, at a price that suits your circumstances.

A medical review company supplies more than a second opinion. The unbiased nature of a medical review company is critical not only to the bottom dollar, but to the final result. Too often, patients think they are just numbers in a file or bits of information in a computer program. The maligned image of an insurance company’s automatic denial of claims without really understanding the patient’s need contributes consumer dissatisfaction and frustration.

What Does It Have to Do With You?

Patients are people and when they need healthcare, they don’t want to read the fine print or a medical dictionary, they just want their claims covered. Most often, it’s unlikely they would realize that their insurance claim went through an Insurance Review Organization’s medical insurance review process. In fact, they probably just fill out the forms, hand a receptionist their insurance card and sign on the necessary release forms.

One of the most common complaints about needing healthcare is the cost followed closely by the complications of paperwork generated through authorization forms, claim forms and more. An insurance review organization is an intermediary company that insurance companies may outsource their claims to in order to determine with medical and insurance coverage accuracy the validity of a claim filed by someone insured by their company.

Your Health Matters

Insurance companies who deny a claim are often portrayed as heartless or more interested in the bottom dollar than they are about showing compassion. This perception is only augmented when an insurance company rejects a claim for anecdotal evidence. When a claim goes through a medical review company’s insurance review process – it will not be rejected or denied based on anecdotal evidence.

For example, a patient suffers from shoulder, back and neck pain as well as bra strap grooving and eczema. Her medical history indicates years of chiropractic treatment as well as advice for non-steroidal anti-inflammatory drugs (i.e. Tylenol, Advil) and worn specialized support bras to support a 34DD frame and all of it to no success. Excessively large breasts can cause many of the symptoms the woman’s medical history indicated.

The doctor recommended a breast reduction procedure to alleviate the problem and the symptoms.

Your Coverage Matters

When the claim is submitted to the insurance company, the policy may not cover elective cosmetic procedures. Many policies do not. Claim managers lacking medical expertise will often compare a procedure request against a list of approved procedures. If cosmetic procedures are not covered, it is likely the claim will be denied. The patient is left either choosing to pay for the procedure out of pocket or continuing to suffer.

If the claim is submitted to a third party intermediary such as a medical review company, the answer will be different. The medical review company has access to a large number of medical specialist and insurance experts. The medical specialists will review the patient’s medical history and the doctor’s recommendations. When her file is reviewed, the third-party specialist will take into account the history of shoulder, neck and back pain. They will note the visits to a chiropractor and other pertinent symptoms.

If the medical specialist agrees with the patient’s physician that she is suffering from Macromastia (excessively large breasts), then he or she will understand that the cosmetic surgery of breast reduction provides the patient with the best option for the patient’s relief.

Confidence Matters

The review process may be transparent to patients whose insurance company uses a medical review company; but the effect is profound. Their coverage premiums will likely be lower. Their medical needs will be addressed. They will not see their healthcare costs rise due to the underwriting of unnecessary procedures. When it comes right down to it, a medical review company gives patients confidence that both their medical and insurance needs will be met. They won’t have to suffer misery unnecessarily nor face collections over mounting debt.