Insurance Information

Front office reception desk at Oral & Maxillofacial Surgical Associates in Metairie, LA

At Oral & Maxillofacial Surgical Associates we make every effort to provide you with the finest care and the most convenient financial options. To accomplish this, we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures. For us to best assist you, please bring your insurance information to your first office visit so that we can expedite your reimbursement.

Our Metairie location is in network with the following dental insurance companies:

  • Delta Dental PPO and Premier
  • Cigna Dental PPO
  • Always Care/ Starmount/ Unum
  • Guardian (Dr. Hyneman only)

Our Bay St. Louis location is in network with the following dental insurance companies:

  • Delta Dental PPO and Premier
  • MetLife
  • Guardian (Dr. Hyneman only)
  • SAS
  • VA 
  • GEHA (coming soon!)

Our Marrero location is in network with the following dental insurance companies:

  • Delta Dental PPO and Premier
  • Cigna Dental PPO
  • Ameritas
  • Guardian 
  • MCNA (for 21 years old and younger) (Dr. Hyneman only)
  • DentaQuest (for 20 years old and younger) (Dr. Hyneman only)
  • VA (Dr. Hyneman only)

Don’t see your insurance carrier? Give us a call to discuss!

Our team is committed to helping patients maximize their insurance benefits and navigate the insurance process as smoothly as possible. As a courtesy, we verify benefits and submit claims on your behalf.

Dental insurance plans vary greatly and coverage determinations are made by the insurance carrier based on your individual policy. While we are happy to assist you, patients are ultimately responsible for understanding their insurance benefits, limitations and exclusions.

Please be aware of the following common insurance limitations/exclusions that may affect claim payment:

  • Annual Benefit Maximums: Most dental plans cap payouts at $1,000 to $2,500 per year. Once this limit is reached, all further expenses are out-of-pocket.
  • Waiting Periods: when enrolling in a new dental policy, there is typically a 6 to 12 month wait time before any major work is covered.
  • Missing Tooth & Pre-existing Exclusions: Conditions present before your policy began, such as a missing tooth, replacement for that tooth may not be covered by your dental plan.
  • Frequency Limitations: Some dental plans restrict how often you can get certain procedures (e.g. panoramic x-rays being covered once every 5 years).
  • IV Sedation Denial: IV sedation is often denied unless rigorous clinical necessity is proven, or a specific number of teeth are being removed at once (e.g. two or more impacted teeth).
  • Downcoding: Insurance carriers systematically lower the code to a reduced payment procedure than the one reported (e.g., surgical extraction being downcoded to a simple extraction).
  • Least Expensive Alternative Treatment (LEAT): If multiple treatments are possible, insurance will only cover the lowest cost option (e.g., tooth replacement: instead of covering a dental implant because of multiple missing teeth in a dental arch, insurance may only cover for a removable partial denture or “flipper”).

The limitations listed above are examples of commonly encountered insurance restrictions. Additional exclusions or limitations may apply based on your specific insurance policy.

Our office provides treatment recommendations based on clinical findings and doctor recommendations – not based on insurance coverage determinations.