How We Handle Your Dental Insurance Claims at Prestige Dental

At Prestige Dental, we are proud to be an out-of-network dental provider; a status that gives us the freedom to prioritize your care over insurance company guidelines. But we understand that navigating out-of-network benefits can feel unfamiliar. That is why we want to walk you through exactly how our claims process works, so you always know what to expect.

The short version: you can absolutely still use your PPO dental insurance at our office in Pasadena. We will do the heavy lifting to help you access every dollar of benefits you are entitled to. Here is how it works, step by step.

Step 1: Payment Is Due at the Time of Your Appointment

When you come in for your appointment, we will review the fees for the services you are receiving that day before we begin. Payment in full is kindly expected at the time of service. We accept all major credit cards, debit cards, checks, and CareCredit financing for your convenience.

We know this is a change from how some insurance offices operate, and we appreciate your understanding. If you ever have questions about the cost of a specific procedure in advance, just ask — we are always happy to give you a clear estimate before your visit.

Step 2: We Submit Your Insurance Claim on Your Behalf — At No Charge

Once your appointment is complete, we will gladly submit a claim to your insurance company as a courtesy to you — at no additional charge. We handle all the paperwork, including any required X-rays, photographs, clinical narratives, and supporting documentation that your insurance company needs to process the claim.

Your insurance company will then send reimbursement directly to you. Depending on your plan and the type of treatment completed, this typically takes 2 to 6 weeks.

Step 3: Following Up with Your Insurance Company

Once the claim has been submitted, it will be your responsibility to follow up with your insurance company to confirm that you have received your reimbursement. Most claims process smoothly and without issue — but if you run into any problems, we are here to help.

If your insurance company requests additional information about a procedure we completed — such as a clinical note, a pre-existing condition determination, or a medical necessity review — please contact us and we will respond promptly to help resolve it.

Step 4: Request a Pre-Authorization Before Your Treatment (Optional)

If you would like to know what your insurance plan is expected to cover for a specific procedure before your appointment, we can submit a pre-authorization request on your behalf. This is a written estimate from your insurance company outlining what they anticipate covering — a useful tool for planning larger treatments such as crowns, implants, or periodontal therapy.

Pre-authorization requests typically take 2 to 6 weeks to process, and both you and our office will typically receive a copy of the response. Keep in mind that a pre-authorization is an estimate, not a guarantee of payment — but it gives you a reliable picture of your expected out-of-pocket costs before treatment begins. If you receive your pre-authorization and have questions about reading or understanding it, bring it in or give us a call — we will go through it with you.

We Are Here to Make It Easy

Navigating dental insurance can feel complicated — but it does not have to be. Our front desk team is experienced in working with a wide range of PPO plans and is always available to answer your billing and benefits questions before, during, or after your visit.

If you have questions about your plan, an upcoming treatment, or how our out-of-network process works for your specific situation, please do not hesitate to reach out. We are committed to making your experience at Prestige Dental as straightforward and stress-free as possible.

Call us at (626) 577-2017 or contact us online to speak with our team.

FAQ SECTION

Q: Does Prestige Dental accept dental insurance?

A: Yes — we accept most major PPO dental insurance plans as an out-of-network provider. This means you can still use your benefits at our office. We submit claims on your behalf as a courtesy, and your insurer reimburses you directly.

Q: What does out-of-network mean for my dental benefits?

A: Out-of-network means Prestige Dental is not contracted with your insurance company, so we set our own fees. However, most PPO plans include out-of-network benefits — meaning they will still reimburse a portion of your treatment costs. We submit your claim for you and you receive payment directly from your insurer.

Q: When do I pay for my dental treatment at Prestige Dental?

A: Payment is due in full at the time of your appointment. We will review all fees with you before treatment begins. We accept major credit cards, debit cards, checks, and CareCredit financing.

Q: How long does it take to receive insurance reimbursement?

A: Once we submit your claim, reimbursement from your insurance company typically arrives within 2 to 6 weeks, depending on your plan and the type of treatment completed.

Q: Can I find out what my insurance will cover before my appointment?

A: Yes. We can submit a pre-authorization request to your insurance company before your treatment. This gives you a written estimate of what your plan expects to cover. Pre-authorizations typically take 2 to 6 weeks and are especially useful for larger procedures like dental implants, crowns, or periodontal treatment.

Q: What if my insurance company needs more information about my treatment?

A: If your insurer requests additional documentation — such as clinical notes, X-rays, or a medical necessity review — contact us and we will respond on your behalf to help resolve the matter promptly.