billing/procedure events timeline

[havezippers]

Hi,
just curious as to whether, for a normal braces situation, the billing and related events timeline. I have incredibly expensive dental insurance which covers most of the braces, at least per the marketing materials they provided, and I have an orthodontics consult tomorrow. It would be ideal if I could get the total or bulk of the cost assigned to occurring this year for purposes of insurance, so that I could drop the insurance for 2017, but not sure how this works. Assuming followup appointments/adjustments are covered in the initial expense or are relatively minor, this would be more affordable. Appreciate the sharing of your experiences, thanks.

[havezippers]

sorry in advance for the bad grammar/typos, I don't see an option to edit---I think the question is still relatively clear...

[verso]

This thread doesn't really apply to me, as I'm paying out of pocket, but I'm curious myself as to how that might work...

[sirwired]

For obvious reasons, the insurance company pays over time, not in a lump sum.

[Leem03]

With insurance your Ortho maximum in generally a calendar year max.

[sirwired]

With my insurance, it was actually a lifetime max. A calendar year max would have been nice, given the length of treatment, but alas...

[shortcircuit]

I have a DHMO through work and this insurance is set up a little differently, there is no yearly or lifetime max. There is a discounted total rate for orthodontics and I have a $1950 copay, this covers two years of treatment and if it goes beyond that then I pay $25 per visit. From a dentist's POV, I can see why very few accept this insurance, the reimbursement rates I see on claims are terrible.

The PPO plan they offer pays only a lifetime max of $1000 toward adult ortho and that's it, you're on the hook for the rest.