Insurance

Insurance Providers, Partners, and Processes

Sprout Dental has what we call a “fair fee” structure. That means fees for services are the same whether patients have a dental insurance program or not.

We consider it a courtesy to patients to complete and submit insurance forms on their behalf. Keep in mind, though, that various insurance programs can cover as little as 30% of the visit or as much as 80%. Very few cover 100%, and almost every dental plan limits dollar disbursement by the insurer.

It’s important to note that our office doesn’t determine policy benefits. We cannot be responsible for structuring your plan. This a pre-existing and pre-determined arrangement between you, perhaps your employer, and your insurance provider.

In the most basic sense, insurance is a contract between the policyholder and the company. We aren’t an insurance company, but we do our best to help you collect legitimate claims.

Importantly, our services are provided at your request. Should your insurance carrier be slow to pay, or for some reason dismisses the claim, payment becomes your responsibility.

Before we begin any treatment, you must be prepared to pay. We accept cash, check, and most major credit cards. We will provide all information necessary to resolve referrals, but request that the insured (the patient) provides this information to the insurer.  Our payment is due from the insured at the time of the visit.

Should you hope to have us submit your insurance benefits, we require insured’s birthdate, social security number, ID number, name and address of employer, occupation, policy number, plan or group number, whichever is applicable.

Sprout Dental works with a number of insurances. A sample of participating insurances is below. If you don’t see your insurance below, feel free to call and inquire. And even if we’re not a participating provider with your insurance company, you’re still welcome to come see us. We’ll do our best to file your claim on your behalf.

Sampling of Participating Insurances
Access PA Medicaid
Aetna Better Health (Scion)
Aetna Group
Ameritas
Amerihealth
Availity
Avesis
Beam Insurance
Cigna
Delta of (AZ, IL, PA, NJ, MI)
Dominion National Dental
Emblem/GHI
EMedNY
Fidelis/Dentaquest
GEHA
Geisinger Family, Kids, Marketplace
Guardian Anytime
Health Now
Healthplex/MVP
Humana
Lincoln Financial Group
Lineco
MBA Merchant Benefits
Metlife
Pipeline Industry
United Concordia
United Health Care
United Health Care CHIP
UPMC

Insurance Questions? Feel free to reach out to us at insurance@sproutdental.com