|
|
Frequently Asked Questions
- Is this dental plan considered "insurance?"
No,
American Dental Plan, founded in 1978 and Arizona's oldest
voluntary dental benefit plan, is classified as a "discount"
dental plan. By joining the Plan, you obtain access to a network
of participating dentists and healthcare providers who are willing
to accept a reduced fee for service in exchange for immediate
payment, no advertising costs, no submitting of claim forms, no
pre-certification checks, and no calculation of deductibles or
co-payments. (It's like having a coupon every time you visit the
dental office.) And unlike traditional insurance, you only pay for
the dental and health services you actually receive without paying
monthly "premiums". There are no waiting periods, no claim forms,
and no limitations to dental services, participation is voluntary
and membership is available regardless of your employment
status.
- Why isn't my dentist on your plan?
Since 1978,
hundreds of Arizona dental offices, (many with multiple dentists), have participated with American Dental Plan; many for over 20 years! Even though we contact dentists on a continual basis to join the provider network, there are reasons why some dentists simply do not wish to reduce their fee. The provider list only includes those dental offices that are currently accepting NEW patients from the dental plan. Those offices who are closed to new patients or unable to accept new patients will not be listed. Certainly feel free to contact your dentist directly or call customer service, (602) 265-6677, to see if your dentist is accepting the Plan.
- Why are the dentists on your plan willing to accept lower
fees?
All of the participating dental offices are
independently owned and operated. These dental facilities
understand the economic benefit of reducing operating costs
associated with advertising, submitting claim forms, waiting for
reimbursement checks from insurance companies, as well as reducing
staff time calling for pre-certification of benefits, verification
of benefits, and having to resubmit claim forms to insurance
companies. And in return, members of American Dental Plan are able
to receive a reduced fee for service without affecting the
profitability of the dental office!
- Can I coordinate my insurance plan with American Dental
Plan?
There are just a few ways to utilize both an
insurance plan and American Dental Plan. First of all, most
insurance plans have waiting periods of 6 months to one year
before certain services can be covered. You can use American
Dental Plan to get the work done immediately without having to
wait. Secondly, most insurance plans will place a yearly dollar
limit on dental services. You can continue your treatment plan by
using American Dental Plan for the extended services and be able
to receive a reduced fee instead of having to wait until the next
calendar year. Third, in some instances, our reduced fee may be
less than your co-payment on your insurance plan. Fourth, should
you change jobs, your employer sponsored plan will terminate but
American Dental Plan will continue regardless of your employment
status. Fifth, most insurance plans do not recognize
co-habitation. Therefore, if you are living together, outside of
marriage, your "significant other", and any dependents, may not
have dental coverage with your employer sponsored plan. And last,
few dental insurance plans provide orthodontic benefits. By using
American Dental Plan, your children can get their braces without
impacting your insurance limits and you can save hundreds of
dollars.
(If you are attempting to coordinate benefits,
we suggest you select a dentist that accepts BOTH dental plans.
This will allow for continuity in dental care. Also, we suggest
you determine which dental plan you will be using for each
specific procedure. This will help minimize clerical errors at the
dental office accounting dept.)
(Remember, if you
are retiring from your current job, dental benefits are seldom
included in your benefits package.)
If you are
enrolled with AFLAC or Allstate indemnity dental insurance, you
may be able to reduce your out-of-pocket expenses by using
American Dental Plan. Call customer service at (602) 265-6677 for
more details!
- Can I use American Dental Plan in another state or with a
dentist "out of network?"
American Dental Plan is only
available in Arizona with those dentists who have signed a
contractual agreement. Only those dentists listed will provide
dental services in accordance with the most recent fee schedule.
There is no reimbursement from the Plan for using "out of network"
dentists.
- How can I change to a different dentist?
If you
decide to change to a different general dentist, for any reason,
just call our customer service department (602) 265-6677 and
obtain a new sticker for the back of your ID card and have your
name placed on the office roster. It is not necessary to obtain a
referral from a general dentist in order to see a specialist on
our dental plan.
- I haven't used my dental plan membership, can I get a
refund?
Once you join American Dental Plan, membership
benefits are available for an entire year. You may assign your
benefits to another person, and they may continue to use the
dental plan for the remainder of the membership period, but there
are no refunds.
- Why aren't all dental procedures listed on your fee
schedule?
Our fee schedule is designed to identify
what we believe to be "basic clinical dentistry". These procedures
have been time tested to provide an economically feasible approach
to providing dental care. Many new techniques are constantly being
created, but at higher fees. And even though these new procedures
may not be specifically identified on the fee schedule, our
providers are willing to offer their "usual cash discounted
prices" on any procedure performed which is not listed on the fee
schedule.
- Why don't we list procedure codes on our fee
schedule?
Each year, new codes are being created to
help identify new procedures or to bundle, or unbundle, previously
coded procedures. By identifying the actual procedure, rather than
using the code, it is easier for the dental office to identify the
correct "discounted" fee for our members. If you are attempting to
submit a claim form to your insurance company for reimbursement,
please discuss all procedure codes with the treating dentist to
ensure accuracy.
- Other competing Plans advertise savings of 50% and
sometimes up to 80%. How is that possible?
Think about
it for just a moment. What successful business person is willing
to discount THAT much of their service and still remain in
business? It is absolutely impossible! The national average
operating overhead of a general dentistry office is 65-75%. How
then can they discount 80% of their normal fee and remain in
business? Those numbers are merely marketing "mirrors" designed to
attract your interest in buying their dental plan. Be sure to ask
about lab fees and other charges the dentist can add back into the
total fee. In many cases, the end result is no different than
paying full price. Be sure to ask questions. It might take some
time, but the facts will speak for themselves.
- Can I transfer my membership from another dental
plan?
If you currently own a competing dental plan and
wish to change plans, send in your original ID cards along with a
completed American Dental Plan application. We will re-issue you
an ADP membership for the remainder of your original dental
plan.
- Do I receive anything for referring others to join
American Dental Plan?
Yes! If you would like to refer
another individual or family and they join the dental plan, you
will receive a $5 coupon that can be used towards your next annual
renewal. Accumulate enough $5 coupons and your dental plan can be
FREE! Think of all your friends, relatives, co-workers,
classmates, etc that might be looking for an affordable
alternative to dental benefits. Call (602) 265-6677 and give us
their name and address. Each application will be sent from our
office with your member # so that we can identify the source of
the application. When we receive the application from the new
member, the $5 coupon will be mailed to you
immediately.
Top Ten Reasons To Use American Dental
Plan
1. ADP is Arizona's oldest voluntary
dental benefit plan, founded in Phoenix in 1978. We have 30 years
direct experience in the Arizona dental plan marketplace. Our
company has been family owned since its inception.
2. The
administrative office is located in Phoenix, AZ. Customer service is
a top priority. The company President will come to your office if
necessary.
3. There are over 650 local dentists, (both general and specialists) that currently participate with ADP. Many have participated for over 20 years! And we maintain our own dental provider network.
4. In almost every situation, you will save
enough money at your first dental visit, (with the free exam and
x-rays) to pay for the cost of your yearly membership!
5. You
only pay for services that you actually receive. Unlike traditional
insurance or prepaid dental plans that require monthly payments
without ever receiving care. It's like having a coupon everytime you
go to your dentist.
6. There are no employment, wage, or age
restrictions.
7. Enrollment is always open.
8. Should
you change employment or retire, your dental benefits will
continue.
9. ADP can be coordinated with traditional
indemnity or PPO plans to cover waiting periods, pre-existing
conditions, gaps in coverage, or any procedure not covered by your
dental insurance plan. Be sure to select a provider that accepts
both dental plans.
10. It is simple and easy to use.
Participation is voluntary and enrollment is always
open.
Additional questions can be answered
by our customer service department between 9:00am and 4:00 pm
Mon-Thursday and until 3:00pm on
Fridays.
|