We're happy to help you understand your dental insurance benefits. We will provide detailed documentation and submit it for reimbursement. Our team can also estimate your insurance coverage before treatment, helping you plan for out-of-pocket expenses. Remember that your maximum and coverage levels reset annually, so we can help you plan treatment timing to maximize your benefits.
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.