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Insurance FAQ

Not every dentist is an in-network or preferred provider of your dental insurance.  You can still receive treatment from these dentists, but you will likely have to pay more.  We recommend that you ask your insurance company to confirm if the dentist you are choosing is both in-network and a preferred provider.  This will give you the best benefit for the premiums you are paying! 

 

Dr. Ashley Spooner, Dr. Melissa Stroup, and the specialists at Falcon Park Dental Group in Highlands Ranch, Colorado 80126 are preferred providers for most PPO and HMO insurances.

 

 

What does it mean for a dentist to be a preferred provider?

 

If a dental office or specific provider is listed as a preferred provider on your insurance, it means that they have signed a contract with your insurance company to accept specific fees according to your plan's fee schedule*. This is great news because your contracted insurance fees are most often LOWER than the cost for services if you were either out of network, in-network but not with a preferred provider, or did not have dental insurance!  By going to a preferred provider you have the peace of mind knowing that the fees are dictated directly by your insurance company.  The insurance companies determine their fees by taking into account usual and customary fees (UCF).  These are the average cost of various dental services in a specified area and then they discount the treatment cost from there.  It is important to know that each insurance plan (even with in the same insurance company) has different fee schedules for services.  Your fee schedules can also change from year to year so please be aware if your plan changes.  The front office team at Falcon Park Dental Group will always do their best to be on the forefront of any changes.  We ask you to please help us and let us know if your plan, employer, or insurance company has changed so we are sure to give you accurate estimates for treatment.  

 

When you come for your first visit at Falcon Park Dental Group, the front office team will have gathered your insurance information when you made the appointment in order to verify your insurance and record your fee schedule into our system.  We will always provide you with an estimate of the cost for your appointment when we are checking you in and if treatment is necessary, we will always discuss this with you prior to starting anything.  We know that surprise bills are never fun and we do our best to give you information up front in order to avoid surprises.

 

*Fee Schedule: A list of each dental service your plan covers and the cost of each service 

ABOUT
HMO
  • You have a specific fee schedule for every service

  • Insurance is reducing the cost of dental services

  • You pay "co-pays" for services

  • Select services under your plan may have a copay of zero dollars!
    You must call you insurance company to be assigned to the dental office you choose, before your first dental appointment

Health Maintenance Organization

ABOUT
PPO
  • You have a specific fee schedule for every service

  • Insurance is reducing the cost of dental services

  • Insurance will pay a percentage towards certain services (listed on their fee schedule)

  • You will have a maximum. This is the most your dental insurance will pay towards services in a calendar year

  • Watch out for waiting periods and missing tooth clauses to get the most out of your insurance

Preferred Provider Organization

If you have questions about your specific dental plan, please call and speak with the front office team at Falcon Park Dental Group, they are your insurance and financing specialists and can help guide you along the way!

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