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Insurance Information

New Direction Dental works with many insurance carriers.

To see if we work with your insurance carrier or dental plan, please call our office for assistance. Our friendly and informed staff will be happy to answer any questions you may have.

We strongly believe our patients deserve optimal dental care.  Dr. Rouse is focused on you choosing your path of care whether optimal or disease control based care.  Dr. Rouse will provide you the options for care then allow you to decide what is best for you both in time and financially. 

We are happy to help you maximize your insurance benefits in our practice.  Our practice will file your claims and estimate your coverage for your convenience.  We pledge to do everything we can as your advocate to ensure that your insurance plan pays the benefits your plan allows.

We are “in network” with some insurance plans, however whether we are PPO or not for your particular plan we invite you to come experience the difference of our office.  We have many patients that chose us because of the high level of care and comfort we provide.   From the latest digital technology, new equipment, instruments, and most important our team that provide your care, we are driven to exceed your expectations of dental care. 

Frankly, Dr. Rouse got into dentistry to help patients receive the best dentistry for them.  Sometimes this is simply preventing issues to begin with, and other times it means restoring damage to the mouth from neglect, trauma, or disabilities.  Ultimately, it is the patients choice on what they decide to do!  Dr. Rouse and our team will be your coach and provider for that journey. 

To provide you some insight on insurance plans and why we may not be a “preferred provider” on your plan, below are some facts about dental insurance plans. 

  1. We explain insurance to patients daily in our practice.  If you have a catastrophic event happen to your house or your vehicle, the insurance company usually provides the cost to rebuild or replace your property.  Dental insurance is more like a supplement.  If you have a cavity or a fractured tooth, they provide 40-70% of the monies for the procedure minus your deductible up to your annual maximum limit.  Most plans only have $1000-$1500 of annual coverage.
  2. Many routine dental services are NOT covered by insurance carriers. In addition,                       many of dentistry’s latest technological advancements are also NOT covered by insurance carriers.
  3. Insurance carriers are more profitable by limiting procedures to minimal repair with ordinary materials. They are committed to a standard of adequacy, while we are committed to a standard of excellence and “optimal care”, which means we would not do anything for you that is less than what we would want for ourselves or our families. Our commitment to excellence goes far beyond just being “good enough”, and we choose to use state-of-the-art technology and materials which are superior to “usual and customary”. Consequently, our fees are often beyond what the carrier allows.
  4. It has been the experience of many dentists that some insurance companies tell their insured that dentist’s fees are “above the usual and customary fees” rather than saying “our benefits are low”.
    • The amount your plan pays is determined by how much your employer paid for the plan. The less he/she paid for the insurance, the less and fewer benefits you will receive. Remember you get back only what your employer put in less the profits of the insurance company.
  5. You may receive a letter from your insurance company stating that dental fees are higher than “usual and customary”. An insurance company surveys a geographic area, finds the average fee, and then takes 70% of that fee and considers it customary. Included in the fee survey are discount clinics which will bring down the average. Any doctor in private practice will have fees that are considered higher than average.
  6. The primary objective of an insurance company is to make a profit for its shareholders. Our primary objective is to help you enhance your oral health and wellness.
  7. Thirty years ago, the average maximum benefit per year was $1,000. If the insurance benefits had kept up with inflation, the maximum per year benefit would be approximately $10,000 today. At present, the average maximum benefit per year is still $1,250– this is equal to about $165 in 1971 dollars. This does not detract from the value of your dental health insurance. We are pleased to help you receive your maximum allowable benefit within our commitment to exceptional service and optimal care.

If you have any questions regarding you insurance, we ask that you contact your company regarding the specifics and details of the plan it is conducting on your behalf.