Cigna Insurance Announcement
Dear Patients,
We appreciate you being a patient of AFC Dentistry and are writing to make you aware of an upcoming change regarding our participation with Cigna Insurance.
Since 2021, Cigna insurance has reduced its payments toward your care. Earlier this year, Cigna announced further reductions in dental coverage (averaging a 30% decrease toward your care). These reductions compromise your health and the care of all Cigna dental patients.
We have appealed to Cigna‘s Provider Services, asking for fees that allow us to continue to participate with Cigna without compromising the excellent level of care we are committed to providing you. Our appeal has gone unacknowledged and remains unanswered.
Since your health and well-being are our top priority, we are unable to continue as a restricted provider with Cigna. We will still accept Cigna insurance and file claims on your behalf as an out-of-network provider.
We’re bringing this change to your attention so you are aware that there may be a difference in your copayments beginning 4/1/24. You will receive reimbursement directly from Cigna Dental insurance. These payments usually are processed within 30 days. If you have a question regarding your existing policy or a claim/payment, please visit Cigna.com or call 1-800-244-6224.
We considered many factors when deciding to no longer be a restricted provider with Cigna insurance and feel this decision reflects our commitment to you, our patients, and to offering the highest level of care and service.
We have also created an in-house membership program that provides a very affordable way to continue to receive the excellent dental care you have come to expect from us. Please feel free to call our team and ask us about the Smile Care Program. You are welcome to use our in-house program and receive its discounts on our services while we submit claims for you to Cigna. Cigna will still send your reimbursement directly to you in the same amount regardless of your enrollment in our membership program.
The annual membership fee is $360 for adults and $150 for children (a child being anyone who still has baby teeth and is 17 years old or younger). Membership includes 2 routine cleanings, 2 checkup exams, 2 fluoride treatments, and routine annual screening X-rays, as well as one emergency exam and an x-ray with that exam. There are other discounted services included with the Smile Care Program and we have attached a copy of the program brochure to this email for you to review the details of membership benefits.
We will make every effort to keep you aware of your financial responsibility before your treatment. Generally, when you or your child is returning for your routine check-up and cleaning visit anticipate co-payments of between $95 and $275 depending on what services you receive during your visit (unless you have enrolled in the Smile Care Program which covers the cost of all routine check-up and cleaning services twice annually).
If you have any questions, please do not hesitate to call our office at (303) 422-0836.
Sincerely,
David A. Zeitlin, DDS & Your Team at Arvada Family and Cosmetic Dentistry
How to get the most out of your Dental Benefits Plan
We want you to get the most out of your dental plan benefits. To confirm how your plan will reimburse you for the dental care we provide you should call your plan and get the answers to the following questions:
- “What kind of out-of-network or in-network benefits do I have?”
- “I need treatment with the following procedure code(s) ___________ _, how much
will I be reimbursed?”(the codes will be on the treatment plan our team reviewed with you) - “What documentation will I, or my dentist’s office need to send you in order to ensure
reimbursement?” - “If you require x-ray radiographs to document completed treatment, will I be reimbursed for the cost of
those x-ray radiographs ?” - “When can I expect that reimbursement to arrive?”
- “What number do I call if I do not get my reimbursement by that date?”
Be sure to also write down the name of the agent you talk with about your plan’s benefits and get a reference number for the discussion so that if you need a follow-up call it will be easier. Below is plan information you should have before calling.
- Plan Name
- Group Number
- Plan ID Number
- Primary Plan Holder _________ (this is the person who bought the plan or gets the plan
through an employer, it may not be the same person who is the patient receiving our care) - Patient Name
Also be prepared to answer questions regarding the plan holder and/or the patient.
You can find the contact information to reach out to your dental plan’s benefits department by calling the number on your dental plan card, searching online, or reaching out to your employer’s human resources
department.
To get the most reimbursement from your plan without delay, call your plan and use this form. At your request, our team will submit any documents to your plan as a courtesy when we complete your care.
