Frequently Asked Questions (FAQs): Other

We recommend that you bring your child in to see Dr. Holder and Dr. Kirkpatrick as soon as their first baby tooth erupts; this may be as early as six months of age.

Of course, when your child’s only six months old, we’re not going to try to do any complicated exams or treatments. During this visit, we’ll focus on educating you about the best ways to care for your child’s teeth as they continue to erupt. We will evaluate their teeth for proper development, brush their teeth, and apply a fluoride varnish because most babies are using a non-fluoridated toothpaste prior to age two. Fluoride strengthens the teeth and helps them to become more resistant to future decay - think of it as a vitamin for their teeth.

We’ll also take the time to show your little one all the interesting equipment and introduce them to our caring staff. Every positive experience your child has with us is a step toward developing a good attitude about dental care. If you’re feeling a little apprehensive about how your child might react, you are always welcome to stay with your child throughout their appointment.

Getting quality dental care for your child is affordable - all insurance plans (PPO or otherwise) will begin covering your child at birth, assuming you have notified your carrier that a child was born and added them to the policy.  Most insurance plans will cover preventative care (exams, cleanings for children, fluoride) at 100%.

Please give us a call to arrange your child’s exciting first dental visit!

A dental sealants is a thin resin-based material that is applied to the uneven chewing surfaces of your child's teeth. The material seals off these deep grooves to prevent food, plaque, and bacteria from collecting, minimizing the risk of decay developing. The back teeth in particular are prone to decay because these uneven surfaces can present a challenge to keep clean with a toothbrush.

Prevention is the key to enjoying healthy teeth. At Zachary J. Holder, DDS, our goal is to use every preventative treatment available to protect your teeth from decay. Application of dental sealants is a very effective procedure and is just one more step we can take to get your child’s teeth off to a healthy start

We need to be proactive with your child’s oral health from an early age. This is the best way to help them enjoy the benefit of strong, healthy teeth that last a lifetime. Our kids are truly lucky to have been born at a time when we can combine our wealth of knowledge with dental treatments that prevent serious oral health problems from developing in the future.

If you would like more information about the benefits of dental sealants or other preventive treatments, please contact our Baytown dental office to arrange a convenient appointment.

Check out the videos below for a quick overview of the proper way to brush and floss your teeth along with a bonus video explaining how to freshen bad breath!

How to Floss

How to Brush

How To Freshen Bad Breath

Diet and Your Teeth

Before we even examine your mouth, we’ll sit down with you for a face-to-face meeting to talk about your concerns. We’ll ask some basic questions to learn more about you and your expectations for dental treatment:

• Are there specific goals you’d like to accomplish, or do you just want to make sure your oral health’s on track?
• What have your past experiences with dental care been like?
• Are you nervous or apprehensive about dental care?

Next, Dr. Holder or Dr. Kirkpatrick examine your teeth and note the condition of current dental work and potential problem areas. We will take intraoral photos and a series of digital x-rays to see if there are any problems developing inside your teeth and to establish a baseline for future treatment.

Since your overall health is important to us, every exam and cleaning includes an oral cancer screening. According to the Oral Cancer Foundation, oral cancer is highly treatable, with a 90% survival rate if caught in its early stages.

The following is a list of the PPO plans we accept. Of those listed, we are in-network with Aetna, MetLife, and United Concordia. We will accept any PPO plans and will file for the patient even if we are not in network with the insurance. We will then bill the patient for the remaining balance. On some insurances that we are out of network with, the insurance company will send a check for payment of their portion of the covered services directly to the patient and the patient can either bring us the check and sign it over to us, or deposit the check and we will simply bill them for the entire amount owed.  

Aetna

Ameritas

Cigna

Delta

Guardian

Humana

MetLife

Principal

Physicians Mutual

UFC

UMR

United Concordia

United Healthcare

We know that understanding the ins and outs of insurance can be challenging. Our team is always here to answer your questions and help you gather the information you need to maximize your benefits

After your visit to the dentist, your insurance administrator reviews your claim to determine your benefits, and you will receive an Explanation of Benefits (EOB) outlining the details of your processed claim. This EOB explains the portion of provider’s charges that are covered under your insurance policy.

A dentist who is part of your provider’s insurance network will usually send your bill to have the network discount the portion you’re responsible for. Next, the claim will be sent on to the administrator of your insurance for processing.

However, if your dentist is not in network with your insurance plan, we will send the bill to you or your insurance company. If you receive the bill directly, you will then submit the claim to your insurance administrator.

At our office, we will usually send the bill to the insurance company first, and once we receive payment from the insurance company for their covered portion we will then send a bill to the patient for the remaining balance. We can usually give the patient a close estimate of what their portion of charges will be, but sometimes there still may be a remaining balance that the patient is responsible for after their insurance company has paid their portion of the balance.

If you have a second dental insurance plan, the two insurance companies will work together to identify which plan is responsible for which portion of the charges. In this case, the administrator of your insurance sends the Explanation of Benefits directly to the provider. Where appropriate, your provider will also receive a reimbursement check. 

Remember that the Explanation of Benefits is not a bill; it simply explains the portion that was covered by insurance. The provider/dental office may bill you separately for any charges you're still responsible for after the insurance company has paid their portion of the charges.

Due to the diverse nature and severity of dental problems, we need to evaluate each case individually before we can determine the amount of cost involved.

We’re happy to provide an initial evaluation and consultation. At that time, we will also discuss the fees associated with your treatment. Your budgetary needs are unique, and we’ll take the time to talk to you about all your options. We’ll work with you and do everything we can to make your treatment as affordable as possible with our easy payment plans.

If you have dental insurance, it’s always a good idea to start by checking with your provider. We will help verify benefits and file forms. We accept a wide number of PPO plans, and you’re welcome to call our office if you have a question about your plan.

At Zachary J. Holder, DDS, we’re also pleased to offer interest-free CareCredit financing. CareCredit is a third-party financing option that allows you to spread your payments over many months. The best place to start is by giving us a call. 

Many patients express concern that that their insurance didn’t provide the benefits that they were expecting to receive. There are many reasons why your dental benefit may vary:

• Maximums limit what a carrier has to cover each year. You may have already used up a portion of the benefits available under your insurance coverage.
• Your plan only pays for a percentage of a particular procedure.
• Your plan limits how many certain types of procedures it will cover, like cleanings, exams, and x-rays.
• The treatment you received was not a covered benefit.
• Your deductible has not yet been met.
• You are ineligible for coverage because you have not yet reached the end of your plan’s waiting period.
• Your insurance may be structured so that you need to choose from a list of your carrier’s preferred providers.       
• Your plan may contain specific limitations for certain procedures.

Dentists deal with thousands of plans and hundreds of types of treatments each year. Most carriers refuse to release the details of their plans. They change policies and reimbursements constantly and without our notice. If you have questions about your coverage, it is always best to check with your carrier first. 

We diagnose and provide treatment using our best professional judgment rather than the cost of care. Employers and insurance plans often exclude coverage for certain necessary treatments as a way of reducing their costs. Even if we determine that a procedure is necessary for your overall oral health, your particular plan may not necessarily cover the cost of treatment.

You may have also noticed that your plan will only pay toward the least expensive alternative treatment. The reason they do this is obvious – to save money. For instance, we may recommend a dental crown while your insurance only offers a benefit toward a filling.

Of course, you’re not required to accept only a filling. The benefit paid will be the same, but your portion of the financial responsibility will be greater. It’s good to keep in mind that it is our job to prescribe the treatment that we know is best for your specific situation. It is the insurance carrier’s responsibility to control payments.

If you’re concerned about coverage for a particular procedure, it’s always best to contact your insurance company. Your insurance coverage is a contract between you, your employer, and the insurance carrier, and you are ultimately responsible for the total cost of your dental treatment. 

First, it’s important to understand that dental insurance isn’t really strictly insurance because it doesn’t actually cover the cost of a loss. Dental insurance is more like a monetary benefit provided by your employer to assist in paying for routine dental treatment.

Each employer selects a plan based on the amount of benefits and the monthly premium cost. Most benefit plans are designed to only cover a portion of the total cost.

UCR (Usual, Customary, and Reasonable) describes the maximum amount an insurance company will allow for a particular dental procedure. Unfortunately, some confusion arises because usual, customary, and reasonable doesn’t really mean exactly what you may think it means. UCR is simply a listing of payments associated with covered procedures. There really isn’t a standard formula or method for determining the UCR, and it isn’t related to the fee that our office charges for a particular service.