All traditional dental insurance plans/Indemnity dental insurance plans are accepted at our office if dental coverage is available.

The following PPO plans are accepted by all general dentists & hygienists at ADG:
Ameritas
Assurant
Blue Cross Blue Shield of Louisiana
Cigna
Delta Dental
Guardian
Metlife
Principle
United Concordia

The following PPOs are accepted by Dr. Tom only:
Dina Dental
Humana
United Healthcare

Our endodontist, Dr. Ruebsamen, is not currently in network with any insurance plans.

The following PPOs are accepted by our oral surgeon, Dr. St. Hilaire:
Blue Cross Blue Shield of Louisiana
Metlife

The following PPOs are accepted by our periodontist, Dr. Fagan:
Blue Cross Blue Shield of Louisiana
Cigna
Delta Dental

Please Note:
We do not accept any Capitation Dental Plans (also known as HMOs) or Discount Plans. See information page on Types of Dental Insurance Plans if you are uncertain if this applies to you.

Your dental plan is designed to share your dental care costs.  The total cost of your bill may not be covered by your insurance plan.  Most plans cover 50-80% of the cost of dental services.  Please check with your insurance plan for details.

We will be happy to file insurance claims on your behalf.  However, should you have questions regarding your specific dental insurance plan, or should you encounter a problem with reimbursement, please contact your employer and/or insurance company first.

Types of Dental Insurance Plans

Discount or Referral dental plans: isn't dental insurance at all. The basis of these dental plans is that a third party (the company who sells the plan) has contracted with dentists (a "closed panel" network of participating dentists) who have agreed to discount their dental fees in exchange for patient referrals from the dental plan company. The company administering the dental plan in essence acts as an intermediary, matching dentists with patients. While the patient does pay a fee to be a member of the dental plan (so the company administering the plan can cover its expenses and earn a profit) payment for dental treatment is directly from the patient to the dentist, as outlined by the plan's predetermined (discounted) fee list.

Dental Insurance Plans

Traditional dental insurance plans / Indemnity dental insurance plans: provides payment for dental treatment received by the covered individual on a traditional fee-for-service basis. For some dental procedures (such as preventive dental care) the payment made by the insurance company.

Usual, Customary, and Reasonable ("UCR") indemnity dental insurance plans: base their payment calculation on either the insurance company's proprietary "usual, reasonable, customary" fee (a "UCR" fee) or else the dentist's fee, whichever is less.  The insurance company will pay their portion of the UCR fee and the patient is responsible for the rest.

Table of Allowances dental insurance plans: utilize a list that outlines the dental procedures covered by the plan. Each procedure on the list has associated with it a set dollar amount that the plan will pay when that particular service is required. Usually the fee found on the insurance company's table is less than what the dentist has charged. In these cases the patient pays the dentist the balance.

Managed Care Insurance Plans

Capitation Dental Plans (Health Maintenance Organizations or HMOs): an arrangement where a dentist (or a dental office) has contracted to provide dental treatment for the dental plan's enrolled members. The provider dentist is paid, usually monthly, a fixed amount per dental plan participant who has selected them to provide their dental treatment. In return it is the dentist's obligation to provide any and all needed dental treatment for these individuals (as specified by the conditions of the dental plan) during the negotiated time frame. The conditions of each capitation insurance plan will vary, but typically some types of dental treatment (exams, cleanings, x-rays) are provided at no charge to the covered individual, while other dental procedures (dental crowns, bridgework, dentures) require a co-payment. Because a negotiated arrangement exists between the dentist and the dental insurance company, dental capitation plans (dental HMO's) are categorized as "closed panel" dental plans. At the extreme, you may only have a single dental office or clinic to choose from when seeking dental treatment.

Preferred Provider Organizations (PPOs): "closed panel" type of dental insurance plan. The insurance company contracts with dentists so to form a network of treatment providers. As a part of the negotiation with the dental insurance company, the dentist, in return for being included in the network and hopefully receiving an increased patient load, has agreed to discount their fees. The covered members of the dental plan must select from this list of network providers when choosing a dentist. Similar in nature to a dental HMO, a dental PPO will encourage you to select your treatment provider from a network of participating dentists. If you do so the dental plan will probably provide its maximum benefits.

Exclusive Provider Organizations (EPOs): another form of "closed panel" dental insurance plan. They are similar in nature to dental PPOs with the exception that you are offered no option other than receiving your dental treatment from a dentist who is a member of the dental insurance company's network of providers.