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Navigating the World of Dental Insurance Terminology

May 9th, 2013

Unless you work for an insurance company, you probably do not spend a lot of your time studying all the terminology that dental insurance companies use to describe the treatments and services they cover. If it seems pretty confusing, here are some of the most commonly used dental insurance terms and what they mean.

A Basic Glossary

Annual Maximum–The maximum amount your policy will pay per year for dental care at Thomas W. Watkins, DDS. It is often divided into costs per individual, and (if you are on a family plan) per family

Co-payment– An amount the patient pays at the time of service before receiving care, and before the insurance pays for any portion of the care

Covered Services– A list of all the treatments, services, and procedures the insurance policy will cover under your contract

Deductible– A dollar amount that you must pay out of pocket each year before the insurance company will pay for any treatments or procedures

Diagnostic/Preventive Services– A category of treatments or procedures that most insurance will cover before the deductible which may include services like routine checkups with Dr. Thomas Watkins, cleanings, X-rays, fluoride treatments, and evaluations

In-Network and Out-of-Network– A list of providers that are part of an insurance company’s “network”

  • If you visit in-network providers, the insurance company will typically cover a larger portion of the cost of the care you receive. If you visit someone who is not part of the network, known as an out-of-network provider, the insurance company may pay for a portion of the care, but you will pay a significantly larger share from your own pocket.

Lifetime Maximum– The maximum amount that a dental insurance plan will pay toward dental care for an individual or family (if you have an applicable family plan)

  • This is not a per-year maximum, but rather a maximum that can be paid over the entire life of the patient.

Limitations/Exclusions– A list of all the procedures a dental insurance policy does not cover

  • Coverage may limit the timing or frequency of a specific treatment or procedure (only covering a certain number within a calendar year), or may exclude some treatments entirely. Knowing the limitations and exclusions of a policy is very important.

Member/Insured/Covered Person/Beneficiary/Enrollee– Someone who is eligible to receive benefits under a dental insurance plan

Provider– Dr. Thomas Watkins or other oral health specialist who provides treatment

Waiting Period– A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments; waiting periods may be waived if you were previously enrolled in another dental insurance plan with a different carrier

There are many different insurance options available, so you need to find out exactly what your insurance covers. It’s important to review your plan with a qualified insurance specialist. Don’t be afraid to ask questions about the policy so you can understand it fully and be confident that you know everything your policy covers the next time you come in for treatment at our Bloomington, IN office.

May Marks National Physical Fitness and Sports Month!

May 2nd, 2013

Did you know the month of May is designated National Physical Fitness and Sports Month? After all, there isn't a better time to celebrate physical activity as when the warm weather and sunshine makes its way back into our lives!

Now that the flowers are in bloom and the weather has warmed up, it's easier to go outside and soak up the sun. After spending the winter working out in gyms or doing crunches at home, exercising outdoors can be a lot more enjoyable as well. Whether you enjoy hikes, jogging, or biking, spring gives us a chance to smell the grass, take in the rays, and enjoy the blue sky—all senses that we just can't duplicate at the gym.

If jogging or biking isn't your cup of tea, we encourage you to try a sport! Sports have some amazing qualities that we often overlook. Team sports like baseball and soccer, and individual sports like golf and tennis can improve your coordination and agility, in addition to building determination, confidence, drive, hard-work, pride, leadership, and time management.

At Thomas W. Watkins, DDS, we always encourage our patients to stay fit by exercising or participating in sports. However, we want to remind you to always wear a mouthguard or other form of facial protection when playing sports. To learn more about how often your child should exercise, or to ask us about obtaining a mouthguard, please give us a call!

How to Handle an Unexpected Dental Emergency

April 25th, 2013

Regardless of the type of dental emergency you experience, it is important that you visit Thomas W. Watkins, DDS for emergency dental care as soon as possible. A chipped or cracked tooth requires professional attention, as bacteria may gather in these areas, potentially causing infection that could require a root canal. Remember, you may be capable of managing pain, bleeding, and swelling at home, but by visiting our office for immediate treatment, you can fight infections and minimize lasting damage to your mouth, teeth, and gums under the expert care of our emergency dentist.

24/7 Emergency Dental Care

Thomas W. Watkins, DDS is proud to offer emergency dental care around the clock, seven days a week. Dental emergencies do not wait for regular business hours, and if you experience a serious dental emergency, you need immediate treatment. Whether you have a broken tooth or if you have bitten through your tongue, do not hesitate to visit us day or night. Until you arrive at our office, however, there are some helpful steps you can take if you encounter a serious dental dilemma.

Managing Your Dental Emergency

If a toothache is causing problems, you can probably keep the discomfort under control until our emergency dentist can treat you. Start by checking the gums that surround the affected tooth for inflammation, bleeding, or foreign objects. There may be food lodged in the gum that could be removed by flossing. You can control pain by placing a cold compress against your mouth, or by using an over-the-counter oral numbing agent.

More serious situations may be extremely time sensitive, and require immediate emergency attention. For example, if a tooth is completely knocked out, carefully clean it with water. Try to place the tooth back into its socket or briefly store it in a cup of milk if it will not fit back into the gum. Never pick up a tooth by the root or force it into the socket. Come straight to our office, as your tooth will need to be replaced within a short amount of time. Similarly, if you have bitten through your lip or tongue, the American Dental Association recommends carefully cleaning the area before coming as quickly as you can to our emergency dental office for treatment.

Remember, there is no reason you should live with discomfort. By visiting our Bloomington, IN office immediately in an emergency, you can take control of your oral health comfortably and safely.

Earth Day

April 18th, 2013

The idea for Earth Day was the brainchild of Gaylord Nelson, a senator from Wisconsin. He envisioned an Earth Day that would be a kind of environmental teach-in. The first Earth Day celebration took place on April 22, 1970, and a surprising 20 million people participated on that day. Ultimately, it became the largest organized celebration in US history.

Earth Day Over the Years

Over the years, the recognition of the day, and the number of people celebrating it all over the world, turned Earth Day into an international celebration. Because it is celebrated throughout the world, it is not only the largest international environmental observation, but it is also more widely celebrated than any other environmental event in the world. Today, Earth Day is celebrated in 175 countries where over 500 million people participate in celebrations.

The Earth Day Movement

The Earth Day movement is credited with developing the idea that people should “think green”. It encouraged congress to enact laws, including one that resulted in the creation of the Environmental Protection Agency. It also inspired the passage of the Endangered Species Act.

The Five R's and Their Importance

  • Reduce – Reduce by avoiding unnecessary purchases. Reduce your use of materials that wind up in landfills. Reduce the use of chemicals around your house. Reduce your use of disposable bags, plates, cups, eating utensils, and batteries.
  • Reuse – Instead of using plastic bags for your groceries or purchases, bring your own reusable bags. When you go to buy coffee at Starbucks, take a travel mug so you don't have to get your coffee in a disposable paper cup. Instead of storing food in disposable refrigerator containers, buy containers that can be washed and reused. Don't use regular batteries. Whenever possible, opt for rechargeable batteries that you can reuse.
  • Recycle – Most cities offer a recycling program to collect used bottles, cans, and newspapers. Recycling includes collecting recyclable materials that would otherwise be considered waste, sorting and processing recyclables into raw materials such as fibers and manufacturing raw materials into new products.
  • Re-buy – Make an effort to purchase things that are made through recycling. When purchasing furniture, look for items that are made from reclaimed wood. When buying paper for kids school work, computer printer paper, holiday cards, or anything else, make a point of purchasing recycled paper products. Instead of buying clothing at full retail price, shop for second hand clothing. You will save a lot of money by doing so!
  • Rethink – Rethink the way you do things so that you do them in an eco-conscious way at all times. Instead of driving to work alone, consider taking the bus or going in a carpool. Walk or ride your bike when you're only going a short distance. Plan your shopping trips and errand runs so that you can do everything on one day, and do it in a way where you can save time and gas.

Other ways to "think green" include growing your own food, composting yard waste and food scraps, or by participating in local recycling programs. Join a group like Freecycle so you can share your unneeded and unwanted possessions with people who can use them. Likewise, you'll be able to get things you need or want for free.

Earth Day teaches people that the planet belongs to everyone, so everyone is equally responsible for protecting it. Although Earth Day is an environmental celebration, our team at Thomas W. Watkins, DDS wants to remind you that you don't have to wait until then to make changes that will allow you and your family to live a greener life.

Happy Earth Day from the team at Thomas W. Watkins, DDS.

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