We Make It Easy

INSURANCE

Kern River Dental is not a fan of dental insurance. It is very expensive for us to process, and rarely covers what the patient thinks it should. We are in the service of dentistry, and insurance companies are in the business of paying out less than they bring in. We are here for you whether you have insurance, or not.

Kern River Dental does not dictate what percentage of your bill your insurance company reimburses. We provide exceptional dental care at UCR rates (industry and regional standard). Your insurance determines what portion of this care they will reimburse. We encourage you to ask your insurance agent what is actually covered before you commit to services from any provider. Our friendly billing staff is happy to walk you through your insurance and help you navigate your insurance billing.

As the patient, you are personally responsible for your dental bill. We make every effort to obtain reimbursement from your insurance company, but uncovered amounts are payable in full at time of treatment.

Like most private dental offices, Kern River Dental is a PPO insurance provider and we accept all PPO insurance or cash payment. There are hundreds of insurance companies and we are in-network with most of them. If we are not a provider in-network with your insurance, or, if your insurance requires you to pay at time of service and be reimbursed from them directly, we are happy to prepare your bill to your insurance companies specification, for you to submit to them directly.

We are not authorized by the Federal government to provide care under MediCare. We are happy to see you on a cash basis. Call your MediCare representative to see if you can be reimbursed for cash payment to our office. We are not aware of any local offices that are authorized to see MediCare patients. Check with your MediCare representative.

We are not authorized by the state to provide care under MediCal. We are happy to see you on a cash basis. Call your MediCal representative to see if you can be reimbursed for cash payment to our office. MediCal offices are generally non-profit dental offices like Clinic Sierra Vista, or others that receive government subsidies and support. We are not aware of any local offices that are authorized to see MediCal patients. Arvin would likely be the closest office.

We are not an HMO provider, however, we are happy to see you on a cash basis and we can prepare your bill to submit to your HMO for reimbursement if you qualify for benefits. An HMO requires a medical office to aggregate several thousand subscribers from the local area to be cost effective, so they work well in larger cities. They are cheap so employers like them, but they offer minimal benefit for your premium. There are simply not enough subscribers locally for this to be cost effective for our small office. Talk with your HMO representative to see if you can be reimbursed for cash payment to our office.

NEED HELP BUT HAVE NO INSURANCE OR FINANCIAL ABILITY TO PAY?

Kern River Dental is a partner with Care Credit®. Care Credit offers easy payment plans for patients who need to spread their payments over time.

INSURANCE TERMS YOU SHOULD KNOW

There are hundreds of insurance companies and thousands of different policies. Each is designed to confuse and confound the insured. Beware any document that requires you read 30 pages of legal writing in order to secure a service. The insurance company is taking the gamble that the amount of money you pay in, will be less than the amount of payment they must make on your behalf. Dental insurance rarely covers what the patient believes it does.

PPO- Insurance that allows you to choose your provider, and provides incentive to use a provider in their network. A PPO is generally seen as the best insurance option, but is often the most expensive. Kern River Dental accepts all PPO insurance, but we are not in-network with all providers. Call us to discuss whether your insurance company reimburses us, or you directly.

HMO- Insurance that pays a physician a small amount each month whether you use their service or not. When you need service, the physician must provide basic service, but may bill you directly for service over and above what the HMO reimburses. HMO’s generally provide basic care, but leave much catastrophic expense out of pocket. HMO’s are a poor choice in a small community because there are not enough participants for a dentist to justify the cost. You often have to travel to Bakersfield or further for care. It is often much less expensive to pay cash for service than to participate in an HMO.

MEDICARE- A government health program for those over 65 years of age. Medicare doesn't cover most dental care, dental procedures, or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices. Medicare Part A (Hospital Insurance) will pay for certain dental services that you get when you're in a hospital. All other expenses are out of pocket. If you purchase a supplemental dental plan, make certain it is a PPO plan.

MediCal/ Denti-Cal- A state program for those who can not afford conventional insurance. We believe in the necessity for MediCal/ DentiCal, but we are not an approved vendor for the State of California. As a result, we can not bill directly to MediCal for your service. We are happy to see DentiCal patients on a cash for service basis. We prepare your bill to submit to DentiCal, or the insurance provider of your choice, but it will likely cover only a small portion of your bill. Please check the terms of your policy to see if all or part of your bill is reimbursable.

CONFUSED BY YOUR BILL?

Let our knowledgeable and polite staff walk you through your bill and help you understand the work done, your policy and coverage.

STANDARD OF CARE

Kern River Dental meets or exceeds every Federal and State Standard. We pride ourselves in our care.

Clients with insurance can often run in conflict with this standard. Insurance promises big and delivers small when it comes to dental insurance. You will often find it less expensive to pay cash for service than to carry dental insurance when amortized over time. More bang for your buck.

At Kern River Dental, we walk you through your care and the cost.  We show you what we recommend, what is required, and where your insurance fails to meet your expectations.  If we find issues with your oral health while conducting an exam, we give you a full diagnosis and you control what work you want done and when you want it done.  At each recommended six month cleaning we can update you on the prognosis of your oral health, allowing you to make critical decisions.  We are partners in your dental care.

UCR RATES

UCR (Usual, customary and reasonable) rates are considered Industry Standard for a region. For instance, UCR rates in California are higher than in Mississippi, because the cost of real estate, employees, liability insurance and other expenses are much higher here. It is more expensive to do business in California, therefore, the UCR rates are higher. The cost of doing business in Kern County is lower than in Los Angeles County, therefore, our UCR is lower here in the Kern River Valley.

*The Federal Dental Act covers “Standard of Care” regulations that dentists must follow. See International Organization for Standardization (ISO) Technical Committee 106 Dentistry (TC 106).