The straight answer to “do you take my insurance?” and why our patients wouldn’t have it any other way.
We are not in-network with any dental insurance plan, PPO or HMO. But we can still use your PPO benefits.
The out-of-network part is on purpose. Give us ninety seconds and we’ll explain why it’s the best thing about this practice, and why it doesn’t mean what you think it means.
We do not participate with any HMO plan, including Medicaid, Healthfirst, and Fidelis. HMO plans pay only the dentists inside their network, which means there is no out-of-network benefit for us to file. Those plans simply cannot be used here. If that’s your plan and insurance-based care is what you need, we understand completely, and we’d rather tell you straight on this page than after you’ve driven over.
(And if you decide you want proof-based care anyway, you’re welcome here as a direct-investment patient like everyone else. The financing options below apply to you too.)
When a dental office joins an insurance network, it signs a contract. The insurance company sets the fees. The fees only work at volume. And volume is how the 20-minute exam was born: more patients per day, less time per mouth, and a schedule that runs the dentist instead of the other way around.
Those are two different lists. Most plans also cap what they’ll pay in a year at a number that hasn’t changed much in decades, and it tends to run out right about where real dentistry begins.
We didn’t think your mouth should be designed by a coverage table. So we never signed.
“Real answers take longer than 20.”
Out-of-network does not mean “no insurance.” Most PPO plans pay out-of-network benefits. (HMO plans are the exception, as above: they pay in-network only.)
Every form, every code, every follow-up call to the insurance company. Handled. Reimbursement goes straight to you.
You’ll see our fee in writing before we begin, and you’ll get an accurate estimate of what your insurance is likely to cover. The numbers go on the table first, so you decide with the facts in front of you.
Seven diagnostic systems decide what’s happening in your mouth. Then you decide what to do about it. Your insurance company is not in the room.
Most PPO plans cover new patient exams, X-rays, and cleanings at or near 100% when you’re seen by an in-network provider. Actual coverage depends on your specific plan, deductible, frequency limits, and waiting periods.
Here’s what we do before your first visit:
You’ll never be surprised by a bill. If your plan doesn’t cover something, we’ll tell you the exact cost before we do it.
Call to Verify My Insurance BenefitsThe identical 90-minute exam: complete Proof Protocol™, your True Wellness Score™, your Whole Mouth Blueprint, and a full cleaning. No middleman, no coverage games.
Ask Donna or Jennifer about the smartest way to structure your care.
Approval takes minutes, most credit profiles qualify, and there’s no hard credit check to find out.
A smile you’ll keep for twenty years shouldn’t hinge on one month’s cash flow.
Financing applies to every patient, insured or not.
We’re out-of-network with all of them, and if yours is a PPO plan, we file claims with all of them. Better than that: your first visit exam and cleaning is preventive care typically covered at or near 100%, because we accept what your plan contributes. Bring your card; Donna or Jennifer will verify your benefits before your visit.
No. Those are HMO plans, and HMO plans pay only in-network dentists. There’s no out-of-network benefit for us to file, so they can’t be used here at all. We don’t participate with any HMO. If you want this level of care anyway, you’re welcome to invest in it directly, and Cherry and Sunbit financing applies.
For your first visit there’s nothing to wait for: with a PPO plan, preventive care is typically covered at or near 100%, because we accept what your plan contributes. For treatment beyond that, most PPO plans pay meaningful out-of-network benefits. Every plan is different, and an estimate is an estimate, not a guarantee. What we promise is this: Donna or Jennifer will get you an accurate estimate in advance, at no charge, so you go in with the facts.
Because the contract changes who the dentist works for. We’d rather earn your fee than bill your code.
Then we’ll phase your Whole Mouth Blueprint: health first, then function, then aesthetics, with Cherry or Sunbit to spread the investment. What we won’t do is shrink the diagnosis to fit a budget. You deserve the truth about your mouth either way. What you do about it, and when, stays in your control.
The New Patient Wellness Exam: the complete Proof Protocol™, your True Wellness Score™, and your Whole Mouth Blueprint. Plan on about 90 minutes; real answers take longer than 20.
Additional services, if needed, are quoted in writing before treatment. Offer valid through 12/31/2026. David Broughton, DDS.