A PPO is a “Preferred Provider Organization”. PPO plans allow you to choose your dental provider and will provide coverage at the dental office of your choice. These differ from DHMO insurance plans that typically cover dental services only at pre-selected providers, which don’t allow you to choose a provider outside of their list of in-network dentists.

We can not submit a claim to your insurance if it is a DHMO or Medicaid plan. These plans have assigned you to a specific dental office that is contracted through your insurance. But we can offer you our self pay rates, for that we do accept HSA/FSA payments when not using your insurance benefits, and offer Carecredit.

Being out-of-network means we are able to provide the highest quality in dental care with the most up-to-date technology without having our treatments or diagnoses dictated by the insurance companies.

LDA does not have a direct contract with your insurance provider. It does not mean we don’t take your insurance— we are able to submit claims for your reimbursement if you have a PPO insurance. We can not submit claims for DHMOs and Medicaid insurances, but we do offer self pay rates.

You can always check with your insurance company to find out what they are and how much they cover. However, our team at LDA can check for you and give you a break down.*

All we need is your carrier name, subscriber ID and date of birth.

*Insurances will never give us an exact dollar amount of what they cover, only percentages based on their “maximum allotted amount”. But they will give you, the enrollee, the exact dollar amount that they will reimburse based on the treatment plan we provide to you.

After your appointment, you pay for fees that are rendered day of and we will submit a claim to your insurance on your behalf. Claims can take up to 14 business days to process* and an insurance check for you reimbursement will be sent to you home from your insurance company.

Here at LDA we can always check for the status of your reimbursement check, and keep you informed at anytime.

*The amount of days can be quicker or lengthier for your reimbursement check to get to you. If you are concerned about the status of your reimbursement, please contact us at LDA, we can always give you a status update on your reimbursement check.

In some cases, yes. Orthodontic coverage under each insurance plan is unique; most plans typically have limitations around age, who on your plan is allowed to use, and how much is offered (i.e. there is a lifetime max versus and annual amount). At LDA, we can tell you what rules are in place for your specific coverage.