Dental Insurance

Dental Insurance

We are a preferred provider for most insurance companies and we accept a large variety of insurance plans. If you have questions about whether Affinity Dental of La Mesa accepts your dental insurance, please call to inquire at (619) 697-2800.

Aetna

Aetna

Phone: (800) 451-7715

Claims Fax: (859) 455-8650

Ameritas

Ameritas Dental PPO

Phone: (800) 487-5553

Anthem

Anthem Blue Cross

Phone: (888) 209-7852

Assurant

Assurant

Phone: (800) 443-2995

Carington

Careington

Phone: (800) 290-0523

Cigna

Cigna

Phone: (800) 882-4462
Fax: (859) 550-2660
Credentialing Fax: (860) 731-2989

Delta Dental

DeltaCare USA

Phone: (800) 422-4234

Claims Fax: (770) 641-5278

Delta Dental

Delta Dental of CA

Phone: (866)499-3001
Alt Phone: (800) 765-6003
Credentialing: (800) 559-5707

Delta Dental

Delta Dental of CA GOV

Phone: (888) 838-8737

First Dental Health

First Dental Health

Phone: (800) 334-7244

Fax: (858) 689-9232

GEHA

GEHA/Connection Dental

Phone: (877) 434-2336

Guardian

Guardian PPO ID #208591

Phone: (800) 541-7846

Provider Relations: (800) 890-4774

HealthComp

HEALTHCOMP

Phone: (559) 499-2450

FAx: (559) 499-2464

Humana

Humana

Phone: (800) 833-2223

Liberty Dental Plan

Liberty

Phone: (888) 704-9830

Metlife

Metlife PPO

Phone: (800) 275-4638

Fax: (859) 389-6505

Metlife

Safeguard/Metlife HMO Facility ID #78261

Phone: (800) 880-1800

Permier Access

Premier Access/Access Dental

Phone: (888) 634-6074

Claims Fax: (916) 646-9000

Principal

Principal Financial (Under FDH)

Phone: (800) 247-4695

Claims Dept: (888) 715-0760

United Concordia Dental

United Concordia Provider ID #004135984

Phone: (866) 357-3304

United Concordia Dental

United Concordia/Military – Active Duty Provider ID #004135984

Phone: (800) 307-8514

United Healthcare

DBP: HMO & PPO Provider ID #12985463

Phone: (800) 822-5333

How Insurance Works

Insurance has two major benefits for the patient: a discounted price on services (resulting in a lower out-of-pocket), as well as offering to cover a portion of the cost of services rendered. When we are in-network with your insurance provider, you are able to utilize the maximum benefits.

The way our estimations work is based on your insurance’s in-network discounted fees. So those are a fixed cost for you, but they can vary each year based on our negotiations with your provider, which may account for different quotes over a number of years. And every insurance company sets its own fees, so if you change insurance companies, the prices will change.

Your out-of-pocket responsibilities can vary according to your annual deductible, your annual maximum, and how much of that maximum you have left for the current plan year. This affects how much insurance will pay for your procedures. So, for example, if you have $100 left in your maximum, and insurance would normally cover $200 for a procedure, they would only pay the first $100 and you would be responsible for the $100 they didn’t cover PLUS your normal out-of-pocket co-insurance. So if you’ve used your benefits at other offices or specialists, the information provided at the time we plan out your treatment may not be completely accurate due to annual maximum usage.

If you have an HMO insurance plan they only cover certain services at a discounted rate and if the service is not covered by your insurance plan you are responsible for the regular price for that service. Because HMO insurance plans are highly discounted, your insurance may not help pay for some of the routine services that are part of the accepted standard of care.

How We Can Help You

Initial Verification: We want to make things as easy as possible for you to enjoy your trip to the dentist, so we try our best to understand your insurance coverage before your visit with us. We ask that you fill out your forms beforehand so that we can verify your insurance & benefits before your visit. This can help cut down on wait times when you arrive.

Approximately 48 hours before your appointment, we will use the online portals provided by your carrier or, if the information is unavailable, we’ll work our way through the automated system to speak to an insurance representative to understand the following:

Your annual maximums & deductibles

Your coverage percentages for Diagnostic & Preventive, Restorative, Periodontal, Endodontic, Oral Surgery, Crowns, and Orthodontic services

Allowable frequencies

We then apply your carrier’s discounted fees to the treatment plan, which updates the total cost & estimated coverage percentages.

Claim Submission: After we submit claims to your insurance carrier, we work with them to provide more information, x-rays, and narratives to ensure the best possibility of pay-out. If we receive denials of coverage for services that weren’t due to frequency, annual maximums, or non-covered services, we will send an appeal on your behalf to encourage their payout. We fight to get you as much as coverage by your insurance as possible.

However, if insurance continues to deny our appeals, the balance on the account is the responsibility of the patient.

Patient Responsibilities

We ask that as soon as your updated insurance information is available, you pass it along to us so we can update your treatment fees (which affects your estimations). A phone call is the quickest way to get the information to us but feel free to email us the information as well. Ultimately, as the policy holder, you are responsible for understanding your coverage and limitations. As the person who pays them, insurance companies will often give you more thorough information.

The following information is usually required to verify your insurance:

Insurance Carrier

Subscriber’s Name

Subscriber’s Date of Birth

Relationship to Subscriber

Member/Subscriber ID/SSN (For Metlife patients, your social security number is REQUIRED for the fastest verification)

Group # (if Known)

Frequently Asked Questions

Canceling & Rescheduling Appointments

To help us ensure all patients have access to treatment and appointments, we kindly require you offer at least 48 hours notice when canceling or rescheduling your appointments.

Many insurance plans include a standard rate for missed appointments which will be added to your account if you do not provide adequate notice before your appointment time.

What if I Don’t Have Dental Insurance?

We welcome patients without insurance. We offer flexible payment options and reduced fees for patients without dental insurance in order to help make dental treatment affordable. Please call our office for details.

Do You Accept Medical?

We currently do not accept MediCal. However, if you would still like to be a patient of ours, we would love to take care of your dental needs. You would be seen as a fee-for-service patient, as we cannot file claims to MediCal.

What Our Patients Are Saying

Are You Ready to Experience the Affinity Dental of La Mesa Difference?

Contact Affinity Dental of La Mesa

Affinity Dental of La Mesa is your trusted partner for all your dental care needs. Experience the difference as we prioritize your comfort, utilize the latest technology, and provide compassionate care. Contact us today to schedule your appointment and take the first step towards a healthier mouth.

Contact Affinity Dental of La Mesa at (619) 697-2800 or click the button below to request an appointment or to learn more about our dental services.