Partnering with Cigna?

I have participated in the Cigna Dental PPO network for four years. For the most part it has been good for my practice, but occasionally not so much. Often when Cigna returns their pre-certifications to my patients, they add a little note that my patient would save money if they used an "advantage" dentist ( a plan that allows a lower fee schedule than the PPO plan). I should note that after signing me up for the DPPO  plan Cigna set up an alternative and less expensive PPO plan named Advantage. (Advantage to Cigna I believe!)   I guess now I am no longer a Cigna "most" Preferred Provider? Cigna offer three tiers of dental plans. DMO, Advamtage PPO and, PPO

Now when Cigna patients call for an appointment and we ask if the have a Cigna PPO plan they sometimes reply yes an make an appointment, but sometimes I am considered an "out of Network Dentist" since I do not participate in the Advantage network. This can lead to an awkward  conversation since it isn't to the callers that Cigna offers more than one PPO options.   Many o are unaware of the three tier structure of providers that Cigna maintains.and hey figure that If they have Cigna and I "take" Cigna, then my practice is in their network. 

The truth is that at least for the Advantage Cigna patients going to a regular Cigna PPO dentist is a viable option, since usually it means that they will experience slightly higher deductibles, but for most the amount should not be a deal breaker ( $25 a year for preventive, $25 for basic and $25 for major services for example). I believe that those with Cigna Advantage should feel free to choose their dentist from either the advantage network PPO network or the regular PPO network. After all their teeth are important and the real "Advantage" in dental insurance is getting the type of dental care that will best preserve your dental health!                                           




from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/01/partnering-with-cigna.html - http://lspindelnycdds.blogspot.com/

Comments

Post a Comment

Popular posts from this blog

Help! My Child is Terrified of the Dentist

Image
If you’re the parent of a young child, you know their brains are similar to sponges that soak up everything around them—especially in their first five years, which neuroscientists say is when they’ll do the most learning and developing in their entire life. At this formative time, your child may amaze you with what they notice: your facial expressions, the different tones of your voice, and your habits. If your habits include regular dental visits and an excellent oral hygiene routine, they’ll notice and want to emulate you. If you happen to feel anxious about your dental visits, or you groan when you’ve got to floss and brush, they may synchronize and feel your dread. This could lead to dental fears that stick with them for years—potentially a lifetime! Kids Can Be Courageous If you’re feeling guilty right now, go ahead and put that away as it won’t serve you or your little one. Everyone has some room for improvement, and Coastal Pediatric Dentistry® is here to help show you an
Read more

Going for the Gold?

Image
On the left is the older allow, on the right the new one that my lab has chosen to use The cost of a penny weight of pure gold is currently $79.53. The cost of a penny weight of pure palladium is $130.6. It used to be that palladium was added instead of gold to the precious metals often used for pfms, but now laboratories are finding that palladium is no longer affordable. The lab that I am using has just changed the formulation of the metal it's using to one that has more gold than palladium. I really do not mind, but metals with more gold are softer and often easier for a dentist to accidentally polish off delicate margins. It is important when polishing "higher gold" formulations to exert less hand pressure when performing the final polishing of the crown's margins. Other wise there should be no problem with this change. Traditionally labs have chosen alloys with higher gold percentages for optimal esthetics, since alloys with higher concentrations of
Read more

Tongue Ties: What Parents Need to Know

Image
For a long time, people just didn’t seem to know much about tongue ties. In the early years of my practice, few of my patients had ever heard of a tongue tie. When I pointed out that they or their children might be tongue tied, I was often the very first practitioner who’d mentioned it to them. When I told them that a tongue tie might actually be the root cause of their oral myofunctional issues, or even their sleep apnea , I’m sure that some of them thought I was crazy. But in the last few years, things have changed so much! Initially, there was a small increase in the number of patients who were contacting me specifically about tongue ties. Dentists and orthodontists also began reaching out more frequently to discuss the application of myofunctional therapy exercises to tongue tie treatment. But in the last year or so, that little bit of interest has become a surge of awareness. Tongue ties and their effects on health and craniofacial development are finally becoming mainstream.
Read more