Coverage. That’s a big issue on the minds of patients and dental care providers. It also applies to the relationship between teledentistry and dental insurance providers.
Of course, most patients want to know if their insurance plan covers dental care. And how much out-of-pocket costs they can expect.
Add teledentistry to the mix and their questions could multiply regarding coverage.
Teledentistry somewhat flew-under-the-radar since the early 2000s. The COVID-19 pandemic increased its visibility and usage beginning in 2020.
Teledentistry is recognized as:
These basic solutions paved the way for innovation around the broader virtual dental care environment. Teledentistry services are now more enticing to patients, dental providers, and insurance payers.
The primary answer is - Yes! Demand and ongoing innovation is helping awaken insurance providers to the patient and provider-centric benefits of teledentistry.
Still, insurance coverage for teledentistry services relies on three factors:
Some flexibility has evolved around state guidelines for teledentistry due to the surge of usage during and post COVID-19. Laws vary from being “extensive” to “non-existent.” [1]
There’s also the variance between what private payers and state medicare programs will reimburse. Again, this is a state by state issue. [2]
”Lawmakers go to a great extent in defining elements of reimbursement including, but not limited to matters like payment parity laws. This law requires insurers to pay for telehealth at the same rate as in-person services, and exists in some states, but not others.” [3]
Payment parity laws (a much broader topic) tend to revolve around these factors:
On a more proactive note here’s a short-list of insurance providers, their coverage details, and links relative to teledentistry.
Medicare
Delta Dental
United Healthcare Dental
Blue Cross Blue Shield
Humana
Humana is among insurance providers who see the value in virtual dental care - including teledentistry.
Humana provides software that connects patients virtually using the dedicated Teledentix platform. According to Teledentix, Humana members can:
The Teledentix virtual dental care and insurance payer solutions (recognized by Humana) are strong examples of what’s possible in this new era of teledentistry.
Insurance coverage is a significant patient expectation when considering teledentistry. The following resources can help you align their expectations with available teledentistry benefits:
Teledentistry or In-Person Dental Visits: Where Do Insurance Reimbursements Apply?
How Teledentistry Can Improve Payer Network Relationships with Providers and Patients
Teledentix is an innovative, turn-key teledentistry solution created by Virtual Dental Care. The all-in-one platform will enable you to adapt teledentistry to your patient care and extend your services beyond the walls of your dental practice…and improve your patient care in the process.
LEARN MORE about the Teledentix platform.
[1] https://mconsent.net/blog/teledentistry-and-insurance-coverage-coding/
[2] https://mconsent.net/blog/teledentistry-and-insurance-coverage-coding/
[3] https://mconsent.net/blog/teledentistry-and-insurance-coverage-coding/
[4] https://mconsent.net/blog/teledentistry-and-insurance-coverage-coding/
[5] https://www.ahip.org/news/articles/yes-teledentistry-is-real-and-it-means-more-access-to-care