Getting the Most From Your Benefits
We practice dentistry. Separately, we help you recover every dollar your plan owes you — including the parts most practices won't put in writing.
Altamar Dental Studio is an independent, family-owned practice, and we're unrestricted. No network tells us which materials to use, which treatment to recommend, or how many minutes you get. That's the whole point, and we're not interested in relitigating it.
What we are interested in is making sure you aren't leaving money on the table. If you carry dental benefits, you paid for them — and we'll help you collect everything they're good for. This page shows you how that works and how to find out what your plan will actually return. If anything here is unclear, call us at (239) 260-5968 and ask.
First, Choose One Path
There are two ways to pay for care here. They cannot be combined, and choosing the right one matters.
Using your dental insurance
Give us your plan information and we'll file the claim for you as a courtesy. Your insurer processes it and sends any reimbursement directly to you — not to us. You pay us at the time of your appointment either way.
Using the Smile Club
Our membership replaces insurance rather than supplementing it. Members get preventive care plus discounts on treatment. Because the discounts are internal, we don't file claims or provide reimbursement documentation for care received under Smile Club pricing. See the plans →
If you have decent dental coverage, use it. If your coverage is poor or you have none, the Smile Club is usually the better deal. We'll help you work out which is which — even if the answer isn't the one that pays us more.
What Actually Happens
You're told the cost before treatment
No surprises, no line items you didn't agree to. You'll know the fee before anything begins.
You pay at the time of your appointment
Payment is due the day of service. For larger treatment plans, HFD and CareCredit financing can break that into monthly payments — both let you pre-qualify with no hard credit pull.
We file your claim
If you've given us your insurance information, we submit the claim on your behalf. You don't have to fill out forms or mail anything.
Your insurer reimburses you directly
The check goes to you, at your address. We never receive it and we have no say in the amount. How much it's for is the subject of the next section — and it's the part you should read closely.
The Part Nobody Tells You
Some plans cover more than 80% of the cost. Some pay zero — for treatment that is absolutely necessary.
We can't tell you in advance which one you have, and we won't pretend otherwise. What we can tell you is where the difference comes from — because it isn't where most people assume.
Your coverage has far less to do with the name on your insurance card than with which specific plan your employer purchased.
Every major carrier sells decent plans and terrible ones. Two patients can hand us cards from the same company and get completely different results, because their employers bought different products. So the useful question isn't "is my insurance good?" — it's "what does my plan actually do?"
Four Things That Determine Your Number
Whether your plan pays for a dentist of your choosing
Some plans only pay when you see a dentist they've contracted with. If yours is one of them, your reimbursement is zero no matter how necessary the treatment is. This is the single most important thing to find out, and it takes one phone call.
Your annual maximum — and what's left of it
Most dental plans cap what they'll pay in a calendar year, commonly between $1,000 and $2,000. That ceiling has barely moved in decades while costs have not stood still. Once you hit it, the plan pays nothing more until January.
Your deductible
The amount you pay before the plan contributes anything. Out-of-network deductibles are often higher than in-network ones, and they reset every year.
The plan's allowed amount
Insurers reimburse a percentage of their allowed amount, not of our fee. A plan that says it covers 80% may be paying 80% of a number well below the actual cost of care. This is where most of the surprise lives.
Get a Real Number Before You Commit
We don't file pre-treatment estimates. They take weeks, they delay care that's already needed, and the form itself says it isn't a guarantee of payment — so they buy you a delay rather than an answer.
Here's what works better. Ask us for the procedure codes and our fee for the treatment you're considering — we'll give you both, gladly. Then call the member services number on your insurance card and ask these five questions. You'll be talking to the people who actually decide, and you'll usually have an answer the same day.
A note on the wording below: insurers call a dentist they haven't contracted with “out-of-network.” It isn't how we'd describe ourselves — we're independent, and unrestricted — but it's the phrase their representatives recognize, so use it with them and you'll get a straight answer faster.
- Does my plan include out-of-network dental benefits? If not, stop here — you have your answer.
- What percentage does my plan reimburse out-of-network for preventive, basic, and major services?
- What is my annual maximum, and how much of it have I already used this year?
- What is my remaining deductible for out-of-network care?
- For procedure code [code we give you], what is your allowed amount for ZIP code 34112 — and are there any waiting periods or frequency limits that apply to me?
Write down the representative's name and the date. If you'd rather not make the call yourself, tell us — we'll walk you through it.
Common Questions
Can I use my HSA or FSA here?
Yes. Dental treatment is a qualified medical expense, and HSA and FSA cards work here like any other card. If you have FSA funds that expire at the end of the year, using them on care you already need is the opposite of wasting them.
Why don't you just join the networks?
Because network contracts set both the fee and, in practice, the treatment. We'd have to choose materials, lab work, and appointment lengths that fit a reimbursement schedule rather than your mouth. We weren't willing to do that. More on that decision →
How long does reimbursement take?
Most insurers process claims within two to six weeks, though it varies. If yours is slow to respond, call them — the claim is between you and your plan, and they answer to you.
What if I have no dental insurance at all?
Then you have nothing to work around, which is simpler than it sounds. Look at the Smile Club — for patients without coverage it's almost always the better value, with no claims, no annual maximum, and no waiting periods.
What do I need to bring for you to file my claim?
Your insurance card and the subscriber's date of birth. If the plan is through a spouse or parent, we'll need their information as the policyholder. Bring it to your first visit and we'll handle the rest.
Can I use insurance for some visits and the Smile Club for others?
No. The Smile Club replaces insurance rather than working alongside it, and we can't provide claim documentation for care received at member pricing. Pick whichever serves you better and stay with it — we're happy to help you compare.
Still Have Questions About Cost?
Ask before you book. We'd rather spend ten minutes on the phone helping you work out whether this makes sense than have you find out afterward that it didn't.