Frequently Asked Questions (FAQs)

Yes! We offer a dental membership plan that many patients find more effective than traditional dental insurance. 

We have dental memberships for adults and children that cover preventive teeth cleanings, x-rays, and exams for one low fee. The membership plan also includes additional savings for other restorative dental procedures to help defray the cost of treatment for families. 

The Benefits of a Dental Membership Plan

There are some aspects of dental insurance that our membership plans eliminate, such as:

• Waiting periods on treatment — Dental insurance often has waiting periods for major treatments, such as dental crowns.
• Yearly deductibles — An insurance plan may impose a deductible that you have to pay before it will make payments. 
• Annual maximums — Dental insurance typically has a maximum amount it will pay each year, ranging from $ 1,000 to $ 2,000, depending on your plan. 
• Treatment limitations — Dental insurance may not cover treatments such as cosmetic dentistry or dental implants. 

Contact Your Augusta Dentist

At West Augusta Dental Associates, we strive to make high-quality dentistry accessible and affordable for all patients. Our dental membership plan plays a key role in achieving this goal. 

For more information about our dental membership plan or to schedule an appointment, please contact our team at (706) 738-8070. 

Dental insurance companies use several factors to determine their "allowed" or "approved" payments for procedures, which often differ from the actual fee charged by West Augusta Dental Associates or other dental practices.

Insurance companies typically create a fee schedule based on what they consider "usual, customary, and reasonable" (UCR) charges for dental procedures in our Augusta, GA, region. These UCR rates are calculated using data collected from various practices, often averaged, and then adjusted downward. The insurance company calculates your benefits using this internal fee schedule, not our actual fees. 

Understanding Network Dental Coverage

For in-network providers, these allowed amounts are contractually agreed upon. Since West Augusta Dental Associates is out-of-network with many plans, there's often a difference between our actual fee and what your insurance considers their allowed amount.

Your specific plan details also influence payment calculations. Plans vary in coverage percentages (typically 50-100 percent, depending on the procedure category), annual maximums, deductibles, waiting periods, and exclusions. These factors affect the final amount your insurance will pay.

Our team works diligently to help estimate your insurance coverage before treatment, but these are always estimates since insurance companies don't guarantee payment until claims are processed.

Contact Our Augusta, GA, Dental Office

If you have questions about how your specific plan calculates payments or need help understanding your benefits, please contact us at (706) 738-8070. We're committed to helping you maximize your insurance benefits while receiving the quality dental care you deserve.

When your explanation of benefits (EOB) indicates that treatment costs exceeded "usual and customary" rates, this doesn't necessarily mean that West Augusta Dental Associates is charging too much for your care.

Understanding Dental Insurance Coverage

Insurance companies establish their own "usual, customary, and reasonable" (UCR) fee schedules based on internal data collection and analysis. These rates are often significantly lower than the actual market rates in the Augusta, GA, area. Each insurance company sets different UCR rates, and they rarely disclose how these figures are calculated or update them regularly to reflect current economic conditions.

As an out-of-network provider, we set our fees based on several important factors: the actual costs of providing quality care, using premium materials, maintaining advanced technology, ensuring appropriate appointment lengths, and fairly compensating our skilled team. Our fees reflect the high standard of care we're committed to providing rather than being limited by insurance company determinations.

Many dental practices in our region charge similar fees for the same high-quality services. The difference you're seeing is often the gap between what insurance companies are willing to pay and the actual cost of providing excellent dental care in today's market.

We're Here for You at West Augusta Dental Associates!

We're always transparent about our fees and work hard to help you maximize your insurance benefits. If you have questions about your EOB or our fee structure, please contact our Augusta dental office at (706) 738-8070. We're happy to review your specific situation.

This is a common question many of our patients ask. Even when you have a remaining balance after insurance, your dental coverage can still provide valuable benefits worth considering.

Dental insurance typically covers 100 percent of preventive care like regular cleanings, exams, and x-rays. This coverage encourages regular maintenance visits that help prevent more extensive and expensive problems down the road. These preventive services alone often justify the cost of premiums for many patients.

For more complex procedures like fillings, crowns, or root canals, insurance usually covers a percentage (commonly 50-80 percent) rather than the full amount. While this does leave you with a balance, your out-of-pocket costs are still significantly reduced compared to having no insurance at all.

At West Augusta Dental Associates, we're committed to helping you understand your insurance coverage and maximize your benefits. 

Alternative Options for Dental Insurance

At West Augusta Dental Associates, we offer an in-house dental membership plan that helps you cover the cost of routine preventive teeth cleanings and checkups for one low membership fee. Members of the in-house dental plan also enjoy additional savings on most restorative procedures. 

If you have specific questions about how your dental insurance plan works with our practice or would like more information about the membership plan, please call us at (706) 738-8070. We're happy to discuss your individual situation and help you make an informed decision.

Yes! As your trusted Augusta dentist, we've been building meaningful relationships with our patients for over 50 years, and we'd love to meet you.

We welcome kids, teens, adults, and seniors to West Augusta Dental Associates, and we pride ourselves on offering a wide range of dental services busy families need to achieve and maintain their smiles in one convenient location.

State-of-the-Art Dental Care in Augusta

While we're well-established in our community, our dental office is also modern and equipped with the latest technology, which helps us streamline dental care. From comprehensive 3-D imaging to our chairside intraoral cameras, all of the technology we choose enhances your dental experience while meeting our high standards of dental care.

We also offer options for dental sedation for fearful patients, making it a comfortable and straightforward experience for them to receive the dental care they need. Consult with our dentists if you believe you could benefit from using dental sedation during your appointments.  

We Look Forward to Meeting You!

If you're searching online for an "Augusta dentist near me," who is accepting new patients, look no further than West Augusta Dental Associates. 

You can schedule an appointment by talking with a friendly team member at (706) 738-8070 or by requesting a visit online. 

While your dental insurance plan may state that routine exams and certain procedures are "covered at 100 percent," this statement requires some clarification to avoid unexpected costs.

When insurance companies indicate 100 percent coverage, they typically mean they'll pay 100 percent of their allowed amount for that procedure—not necessarily 100 percent of the actual fee charged by West Augusta Dental Associates. Since we're out-of-network with many insurance plans, there may be a difference between our fee and what your insurance considers their "allowed" amount.

Understanding Insurance Limitations

Additionally, insurance plans often have limitations that affect coverage, even for "100 percent covered" services. These may include:

• Annual frequency limitations (such as covering only two exams per year)
• Deductibles that must be met before coverage applies
• Waiting periods for new policyholders
• Exclusions for certain types of exams or related services

Our team at West Augusta Dental Associates will help you understand your specific coverage before treatment and submit all necessary documentation to maximize your benefits. We can provide pre-treatment estimates to help you anticipate any potential out-of-pocket expenses.

Contact Your Dentist in Augusta, GA

For questions about how your specific insurance plan works with our practice or to verify coverage before your appointment, please contact our dental office at (706) 738-8070. We're committed to helping you navigate your dental benefits while receiving quality care.

We understand the disappointment when insurance doesn't cover a treatment you expected. If you find yourself in this situation, there are several steps you can take to address the issue.

First, contact our Augusta dental office at (706) 738-8070. Our experienced team can review your insurance policy details and help determine why the claim was denied. Common reasons include waiting periods, frequency limitations, annual maximums, or the procedure being classified as cosmetic rather than medically necessary.

Consider requesting a written explanation of benefits (EOB) from your insurance company if you haven't received one. This document explains their decision and outlines your appeal rights. Most insurance companies have an appeals process that allows you to contest their determination.

We're Here to Support You

Our staff can help prepare documentation to support your appeal, including clinical notes, x-rays, or a letter of medical necessity from your dentist explaining why the recommended treatment is appropriate for your specific condition.

If your appeal is unsuccessful, ask our office about alternative payment options. We offer flexible payment plans with CareCredit and will work with you to accommodate your budget for dental care.

Remember that insurance policies vary significantly in their coverage details. We're committed to helping our patients navigate these challenges and access the dental care they need. Don't hesitate to reach out to us at (706) 738-8070 with any insurance questions or concerns.

At West Augusta Dental Associates, we understand the frustration of unexpected dental costs. Dental insurance plans vary significantly in coverage, and several factors may explain why your treatment isn't fully covered.

• Coverage Limitations — Most dental plans have annual maximums (typically $1,000–$2,000) that cap what the insurance company will pay within a calendar year. Once you reach this limit, you're responsible for the remaining costs, regardless of necessity.
• Treatment Classification — Insurance companies categorize procedures into preventive (cleanings, exams), basic (fillings), and major (crowns, bridges) treatments. Major procedures often have lower coverage percentages—sometimes only 50 percent—while preventive care might be covered at 100 percent.
• Pre-existing Conditions — Some plans don't cover pre-existing conditions or have waiting periods for certain procedures, particularly for new policyholders.
• Alternate Benefit Provisions — Insurance may only cover the least expensive treatment option for a particular condition, even when your dentist recommends a different approach based on your specific needs.
• Network Restrictions — Coverage may be reduced if you see providers outside your plan's network.

We're Here to Help!

We're committed to helping you navigate these complexities. Our team can provide pre-treatment estimates, discuss payment options, and work with you to maximize your benefits while ensuring you receive optimal care.

Have more questions about your coverage? Please call your trusted Augusta dentist at (706) 738-8070; our friendly staff will gladly assist you.

At West Augusta Dental Associates, we understand that insurance coverage is an important consideration in your dental care decisions. Our practice has chosen to remain out-of-network with many dental insurance plans for several key reasons.

Prioritizing Patient-Centered Care

Being out-of-network allows us to prioritize quality care over insurance company requirements. Insurance networks often impose limitations on treatment options, materials used, and time spent with patients. By remaining independent, your Augusta dentist can recommend the best treatments based solely on your oral health needs rather than insurance restrictions.

We believe in transparent pricing and personalized care. Insurance networks typically negotiate reduced rates that can sometimes lead to compromises in service quality or rushed appointments. Our dental practice maintains fair pricing while ensuring we dedicate appropriate time and attention to each patient.

While we don't participate directly in many networks, we still work with your insurance. As a courtesy, we file claims for you and help maximize your benefits. Many insurance plans offer out-of-network coverage, often covering a significant portion of your treatment costs and reimbursing you directly.

We're happy to provide pre-treatment estimates and discuss financial arrangements that work for your budget. Our team is experienced in helping patients understand their insurance benefits and optimize their coverage.

Contact West Augusta Dental Associates for More Information

If you have questions about how your specific insurance plan works with our practice, please contact our Augusat, GA, dental office at (706) 738-8070. We're committed to making quality dental care accessible while maintaining our high standards of excellence. 

Absolutely! While West Augusta Dental Associates may not be in your specific dental plan's network, we welcome patients with all types of dental insurance coverage.

When you visit an out-of-network provider like us, your insurance plan may cover a smaller percentage of the cost than in-network providers or use a different fee schedule to determine reimbursement. However, many patients find that the quality of care, personalized attention, and comprehensive services your trusted Augusta dentist provides make any potential difference in out-of-pocket expenses worthwhile.

Understanding Out-of-Network Dental Care

Here's how we make it work for you:

We'll verify your out-of-network benefits before treatment so you understand your coverage levels and potential costs. Many plans still provide partial coverage for out-of-network care.

Our office staff will help submit insurance claims on your behalf, ensuring you receive all entitled reimbursements directly from your insurance company.

We offer flexible payment options for any remaining balances to accommodate your budget, including payment plans for extensive treatments.

Many patients are surprised to learn their out-of-pocket costs aren't significantly different than with in-network providers, especially for preventive care.

Your oral health is too important to be limited by network restrictions. Call us at (706) 738-8070 to discuss your specific insurance situation, and let us help you maximize your benefits while receiving the exceptional dental care you deserve.

If you're unhappy with the appearance of your teeth, cosmetic dentistry may be exactly what you need to feel more confident in your smile. From professional teeth whitening and veneers to dental bonding and dental implants, there are a variety of treatments designed to enhance both the appearance and function of your teeth.

Cosmetic dentistry can help with:

• Discoloration
• Chips
• Gaps
• Unevenness
• Missing teeth

Our Approach Is Focused on You and Your Needs

At West Augusta Dental Associates, we take a personalized approach to every cosmetic case. During your consultation with our cosmetic dentist in Augusta, we’ll take time to understand your concerns, your goals, and any budget considerations. We’ll also evaluate your oral health to ensure that there are no underlying issues, such as gum disease or decay, that need to be addressed before moving forward.

Ideal Candidates

Ideal candidates for cosmetic dentistry are generally in good oral health, committed to maintaining their results, and realistic about what cosmetic procedures can achieve. If you're preparing for a significant life event or simply ready to invest in yourself, we’re here to help you achieve a healthy, radiant smile that suits your lifestyle.

Call Our Cosmetic Dentists in Augusta, GA 

Not sure where to start? Come see us for a smile consultation, and we’ll help you discover what’s possible!

We offer the Opalescence custom take-home whitening system, a professional-grade solution that provides excellent results in the comfort of your own home.

Our teeth-whitening system is customized specifically for you. The process begins with an appointment where we take impressions of your teeth to create perfectly fitted plastic whitening trays. These custom trays ensure the whitening gel evenly contacts all tooth surfaces while minimizing exposure to sensitive gum tissue.

Why Choose Professional Teeth Whitening in Augusta?

The Opalescence system uses professional-strength whitening gel that's more effective than over-the-counter options. The gel contains potassium nitrate and fluoride, which help reduce sensitivity and strengthen enamel while whitening your teeth. Our dental team will recommend the appropriate gel concentration based on your specific needs and sensitivity level.

We provide detailed instructions on using your custom trays and whitening gel effectively. Most patients see noticeable results within a few days, with optimal results typically achieved after 1–2 weeks of consistent use. The custom trays are reusable, allowing you to perform touch-up treatments as needed.

Take-home whitening offers the advantage of convenience while still being supervised by dental professionals. We'll schedule a follow-up appointment to ensure you achieve the desired results and address any questions. 

To learn more about our professional teeth bleaching system or schedule an evaluation, please contact our dental office in Augusta at (706) 738-8070. We're excited to help you achieve a brighter, more confident smile!

On average, dental crowns in Augusta can last between 10 to 15 years, but with proper care, many patients enjoy their crowns for 20 years or more. Their longevity depends on a few key factors: 

• Material of the crown
• Your oral hygiene routine
• Daily habits like what you eat and how you protect your teeth

Ceramic and porcelain resemble natural teeth, while metal or porcelain-fused-to-metal crowns are recognized for their strength and are often used on back teeth. Regardless of the material, maintaining good oral hygiene and regular dental checkups is crucial for keeping your crown and tooth healthy.

Caring for Your Dental Crown 

To extend the lifespan of your crown, we recommend avoiding very hard or sticky foods that can crack or loosen the restoration. If you grind your teeth at night (a condition known as “bruxism”), wearing a night guard can also help prevent excess wear and tear. Always brush, floss, and practice good oral health habits—and your smile will last for years!

Dental Crowns in Augusta, GA 

At West Augusta Dental Associates, we’ll help you choose the best type of crown for your needs and provide guidance on how to care for it. With the right maintenance, your crown can be a long-lasting investment in your smile and overall dental health.

Contact us today to schedule a consultation at our Augusta dental office.

At West Augusta Dental Associates, we recommend dental crowns in Augusta, GA, when a tooth's structure has been significantly compromised and needs protection. Understanding when a crown becomes necessary can help you make informed decisions about your oral health.

Extensive Decay or Damage 

When a tooth has severe decay that's too extensive for a filling, a crown becomes the best solution. A crown completely covers the compromised tooth, restoring its integrity and preventing further damage from spreading.

After Root Canal Treatment

Following root canal therapy, teeth become more brittle and prone to breaking. A crown provides essential protection, ensuring the treated tooth can withstand normal chewing forces without fracturing.

Cracked or Fractured Teeth 

When teeth develop significant cracks or fractures, crowns hold the remaining tooth structure together while restoring full function. This prevents the crack from worsening and potentially requiring extraction.

Worn Down Teeth 

Teeth severely worn from grinding, clenching, or acid erosion may need crowns to restore their proper height and function. This also protects against further wear and improves your bite.

Large Existing Fillings 

When a tooth has a large filling that's failing or when there's more filling material than natural tooth structure remaining, a crown provides better long-term stability and protection.

Concerned about a damaged tooth? Call our Augusta dental office at (706) 738-8070 to schedule an evaluation.

At West Augusta Dental Associates, we understand the frustration of unexpected dental costs. Dental insurance plans vary significantly in coverage, and several factors may explain why your treatment isn't fully covered.

• Coverage Limitations — Most dental plans have annual maximums (typically $1,000–$2,000) that cap what the insurance company will pay within a calendar year. Once you reach this limit, you're responsible for the remaining costs, regardless of necessity.
• Treatment Classification — Insurance companies categorize procedures into preventive (cleanings, exams), basic (fillings), and major (crowns, bridges) treatments. Major procedures often have lower coverage percentages—sometimes only 50 percent—while preventive care might be covered at 100 percent.
• Pre-existing Conditions — Some plans don't cover pre-existing conditions or have waiting periods for certain procedures, particularly for new policyholders.
• Alternate Benefit Provisions — Insurance may only cover the least expensive treatment option for a particular condition, even when your dentist recommends a different approach based on your specific needs.
• Network Restrictions — Coverage may be reduced if you see providers outside your plan's network.

We're Here to Help!

We're committed to helping you navigate these complexities. Our team can provide pre-treatment estimates, discuss payment options, and work with you to maximize your benefits while ensuring you receive optimal care.

Have more questions about your coverage? Please call your trusted Augusta dentist at (706) 738-8070; our friendly staff will gladly assist you.

Healing after dental implant placement surgery is typically between three and six months. 

During this time, we're allowing your biocompatible dental implant to fully fuse and integrate with your jawbone through a process called osseointegration. When your implant is fully integrated with your bone, it is completely stable, just like your tooth root, and ready to support your restoration, a custom porcelain crown. 

It is this process that makes dental implants so unique because they are the only procedure that replaces both your tooth and root. This is important because without a root to support, your jawbone begins to deteriorate, which can impact support for your facial structure and neighboring teeth, resulting in more tooth loss.

Why Choose Dental Implants?

Dental implants offer several advantages for patients that make them the gold standard in tooth replacement. 

• Excellent Aesthetics — A dental implant looks and feels like a natural tooth.
• Superior Function — Chewing and eating are comfortable and easy because your implant is just like a natural tooth.
• Exceptional Longevity — A dental implant can potentially last for a lifetime with the proper care. 
• Bone Protection — An implant keeps your jawbone healthy.
• Bite Stabilization — Dental implants protect bite alignment, which promotes jaw joint (TMJ) health. 

Would you like to learn more about dental implants in Augusta, GA? Contact West Augusta Dental Associates at (706) 738-8070 and book an evaluation with one of our dentists. We can complete the entire process from start to finish in the comfort of our dental office. 

Recovery after dental implant surgery is important for successful healing and long-term success. At West Augusta Dental Associates, we want your dental implants in Augusta, GA, to heal properly and last for decades. Following proper dietary guidelines during your recovery is essential for the best results.

Immediately After Surgery

During the initial healing phase, stick to soft, cool foods that won't irritate the surgical site. Avoid anything that requires excessive chewing or could dislodge the blood clot forming around your implant. Cold foods like smoothies, yogurt, and ice cream can actually help reduce swelling and provide comfort.

Foods to Avoid During Early Recovery

Hard, crunchy, or sticky foods can interfere with healing and potentially damage the implant site. Skip items like nuts, chips, popcorn, and hard candies. Spicy foods may cause irritation, while extremely hot beverages can disrupt the healing process. Carbonated drinks should also be avoided as they can cause discomfort and interfere with clot formation.

What You Can Enjoy

Focus on nutrient-rich soft foods that support healing. Warm (not hot) soups, mashed potatoes, and protein smoothies are excellent choices. According to the American Dental Association, maintaining a diet of soft foods and warm soup during the healing process helps ensure proper recovery.

Gradual Return to Normal Diet

As your implant heals and integrates with your jawbone through osseointegration, you can gradually reintroduce firmer foods. This process takes time, and we'll guide you through each stage of your recovery.

Questions about your post-implant diet? Call our Augusta dental office at (706) 738-8070 for personalized guidance on your recovery journey.

At West Augusta Dental Associates, we understand that insurance coverage is an important consideration in your dental care decisions. Our practice has chosen to remain out-of-network with many dental insurance plans for several key reasons.

Prioritizing Patient-Centered Care

Being out-of-network allows us to prioritize quality care over insurance company requirements. Insurance networks often impose limitations on treatment options, materials used, and time spent with patients. By remaining independent, your Augusta dentist can recommend the best treatments based solely on your oral health needs rather than insurance restrictions.

We believe in transparent pricing and personalized care. Insurance networks typically negotiate reduced rates that can sometimes lead to compromises in service quality or rushed appointments. Our dental practice maintains fair pricing while ensuring we dedicate appropriate time and attention to each patient.

While we don't participate directly in many networks, we still work with your insurance. As a courtesy, we file claims for you and help maximize your benefits. Many insurance plans offer out-of-network coverage, often covering a significant portion of your treatment costs and reimbursing you directly.

We're happy to provide pre-treatment estimates and discuss financial arrangements that work for your budget. Our team is experienced in helping patients understand their insurance benefits and optimize their coverage.

Contact West Augusta Dental Associates for More Information

If you have questions about how your specific insurance plan works with our practice, please contact our Augusat, GA, dental office at (706) 738-8070. We're committed to making quality dental care accessible while maintaining our high standards of excellence. 

Absolutely! While West Augusta Dental Associates may not be in your specific dental plan's network, we welcome patients with all types of dental insurance coverage.

When you visit an out-of-network provider like us, your insurance plan may cover a smaller percentage of the cost than in-network providers or use a different fee schedule to determine reimbursement. However, many patients find that the quality of care, personalized attention, and comprehensive services your trusted Augusta dentist provides make any potential difference in out-of-pocket expenses worthwhile.

Understanding Out-of-Network Dental Care

Here's how we make it work for you:

We'll verify your out-of-network benefits before treatment so you understand your coverage levels and potential costs. Many plans still provide partial coverage for out-of-network care.

Our office staff will help submit insurance claims on your behalf, ensuring you receive all entitled reimbursements directly from your insurance company.

We offer flexible payment options for any remaining balances to accommodate your budget, including payment plans for extensive treatments.

Many patients are surprised to learn their out-of-pocket costs aren't significantly different than with in-network providers, especially for preventive care.

Your oral health is too important to be limited by network restrictions. Call us at (706) 738-8070 to discuss your specific insurance situation, and let us help you maximize your benefits while receiving the exceptional dental care you deserve.

This is a common question many of our patients ask. Even when you have a remaining balance after insurance, your dental coverage can still provide valuable benefits worth considering.

Dental insurance typically covers 100 percent of preventive care like regular cleanings, exams, and x-rays. This coverage encourages regular maintenance visits that help prevent more extensive and expensive problems down the road. These preventive services alone often justify the cost of premiums for many patients.

For more complex procedures like fillings, crowns, or root canals, insurance usually covers a percentage (commonly 50-80 percent) rather than the full amount. While this does leave you with a balance, your out-of-pocket costs are still significantly reduced compared to having no insurance at all.

At West Augusta Dental Associates, we're committed to helping you understand your insurance coverage and maximize your benefits. 

Alternative Options for Dental Insurance

At West Augusta Dental Associates, we offer an in-house dental membership plan that helps you cover the cost of routine preventive teeth cleanings and checkups for one low membership fee. Members of the in-house dental plan also enjoy additional savings on most restorative procedures. 

If you have specific questions about how your dental insurance plan works with our practice or would like more information about the membership plan, please call us at (706) 738-8070. We're happy to discuss your individual situation and help you make an informed decision.

We understand the disappointment when insurance doesn't cover a treatment you expected. If you find yourself in this situation, there are several steps you can take to address the issue.

First, contact our Augusta dental office at (706) 738-8070. Our experienced team can review your insurance policy details and help determine why the claim was denied. Common reasons include waiting periods, frequency limitations, annual maximums, or the procedure being classified as cosmetic rather than medically necessary.

Consider requesting a written explanation of benefits (EOB) from your insurance company if you haven't received one. This document explains their decision and outlines your appeal rights. Most insurance companies have an appeals process that allows you to contest their determination.

We're Here to Support You

Our staff can help prepare documentation to support your appeal, including clinical notes, x-rays, or a letter of medical necessity from your dentist explaining why the recommended treatment is appropriate for your specific condition.

If your appeal is unsuccessful, ask our office about alternative payment options. We offer flexible payment plans with CareCredit and will work with you to accommodate your budget for dental care.

Remember that insurance policies vary significantly in their coverage details. We're committed to helping our patients navigate these challenges and access the dental care they need. Don't hesitate to reach out to us at (706) 738-8070 with any insurance questions or concerns.

Dental insurance companies use several factors to determine their "allowed" or "approved" payments for procedures, which often differ from the actual fee charged by West Augusta Dental Associates or other dental practices.

Insurance companies typically create a fee schedule based on what they consider "usual, customary, and reasonable" (UCR) charges for dental procedures in our Augusta, GA, region. These UCR rates are calculated using data collected from various practices, often averaged, and then adjusted downward. The insurance company calculates your benefits using this internal fee schedule, not our actual fees. 

Understanding Network Dental Coverage

For in-network providers, these allowed amounts are contractually agreed upon. Since West Augusta Dental Associates is out-of-network with many plans, there's often a difference between our actual fee and what your insurance considers their allowed amount.

Your specific plan details also influence payment calculations. Plans vary in coverage percentages (typically 50-100 percent, depending on the procedure category), annual maximums, deductibles, waiting periods, and exclusions. These factors affect the final amount your insurance will pay.

Our team works diligently to help estimate your insurance coverage before treatment, but these are always estimates since insurance companies don't guarantee payment until claims are processed.

Contact Our Augusta, GA, Dental Office

If you have questions about how your specific plan calculates payments or need help understanding your benefits, please contact us at (706) 738-8070. We're committed to helping you maximize your insurance benefits while receiving the quality dental care you deserve.

The quick answer is that healthy patients can visit their dentist every six months for exams and dental cleanings in Augusta, GA. However, patients who are managing gum disease may need additional teeth cleanings throughout the year to successfully control their condition.

So the true answer is that your hygiene schedule is highly personalized, and our dentists will tailor it to your unique needs. 

Understanding Gum Disease

There is no cure for advanced gum disease (periodontitis), so it's essential to stay on top of your dental health with routine preventive teeth cleanings and exams every six months. During these visits, our dentists screen for concerns like gum disease and tooth decay, so we can often help you detect problems early on before they become more significant concerns. 

Gingivitis, or early gum disease, can often be reversed if we spot it early and you are proactive about making the necessary changes to your home care routine. 

Protecting your smile against gum disease also protects your overall health and well-being since it's closely linked with non-dental concerns like:

• Heart disease
• Diabetes
• Rheumatoid arthritis
• Dementia
• High blood pressure
• Stroke

Gum disease is also linked with pregnancy complications, such as low birth weights and pregnancy diabetes. 

Contact us at (706) 738-8070 if it's time for your next teeth cleaning and dental exam in Augusta, GA.

While your dental insurance plan may state that routine exams and certain procedures are "covered at 100 percent," this statement requires some clarification to avoid unexpected costs.

When insurance companies indicate 100 percent coverage, they typically mean they'll pay 100 percent of their allowed amount for that procedure—not necessarily 100 percent of the actual fee charged by West Augusta Dental Associates. Since we're out-of-network with many insurance plans, there may be a difference between our fee and what your insurance considers their "allowed" amount.

Understanding Insurance Limitations

Additionally, insurance plans often have limitations that affect coverage, even for "100 percent covered" services. These may include:

• Annual frequency limitations (such as covering only two exams per year)
• Deductibles that must be met before coverage applies
• Waiting periods for new policyholders
• Exclusions for certain types of exams or related services

Our team at West Augusta Dental Associates will help you understand your specific coverage before treatment and submit all necessary documentation to maximize your benefits. We can provide pre-treatment estimates to help you anticipate any potential out-of-pocket expenses.

Contact Your Dentist in Augusta, GA

For questions about how your specific insurance plan works with our practice or to verify coverage before your appointment, please contact our dental office at (706) 738-8070. We're committed to helping you navigate your dental benefits while receiving quality care.

When your explanation of benefits (EOB) indicates that treatment costs exceeded "usual and customary" rates, this doesn't necessarily mean that West Augusta Dental Associates is charging too much for your care.

Understanding Dental Insurance Coverage

Insurance companies establish their own "usual, customary, and reasonable" (UCR) fee schedules based on internal data collection and analysis. These rates are often significantly lower than the actual market rates in the Augusta, GA, area. Each insurance company sets different UCR rates, and they rarely disclose how these figures are calculated or update them regularly to reflect current economic conditions.

As an out-of-network provider, we set our fees based on several important factors: the actual costs of providing quality care, using premium materials, maintaining advanced technology, ensuring appropriate appointment lengths, and fairly compensating our skilled team. Our fees reflect the high standard of care we're committed to providing rather than being limited by insurance company determinations.

Many dental practices in our region charge similar fees for the same high-quality services. The difference you're seeing is often the gap between what insurance companies are willing to pay and the actual cost of providing excellent dental care in today's market.

We're Here for You at West Augusta Dental Associates!

We're always transparent about our fees and work hard to help you maximize your insurance benefits. If you have questions about your EOB or our fee structure, please contact our Augusta dental office at (706) 738-8070. We're happy to review your specific situation.