Insurance Notice

Our patients are our first priority and we want to assure that you get the highest standard of care at Mid-City Smiles.  We have been an in-network provider since we opened in 2009. We are constantly working with the insurance companies to assure that the services provided in our office are processed and approved at the maximum benefit for our patients AND the provide the level of care that is most important to both you and us.
We are choosing you.

NETWORK STATUS UPDATES

We will do our best to add any information we have about our insurance relationships below. Feel free to email BILLING@MIDCITYSMILES.COM with any insurance questions/concerns or if you don’t see your insurance listed. Updated 1.31.25

In-Network

  • Aetna
    • Medicare, Standard, Reliance, Principal, Renaissance, Ameritas, Meritain, Christian Brothers, Ebix, and more…
  • BCBS – Louisiana only
  • Cigna
    • APWU, Health Plan, Seafearers, SHBP, and more…
  • Delta Dental – all states
  • Dina/Ochsner Health Plan
  • GEHA – some of their plans fall under UnitedHealthcare
  • Humana – all regular plans, Medicare, NOT EPO/FEDVIP
  • SunLife/DHA
    • Mutual of Omaha, Equitible, Cypress
  • United Concordia
  • United Health Care
    • GEHA (2025), Medicare, Lincoln, Freedom Life, Beam, People’s Health, and more…

Out-of-Network – pays same percentages. Some plans make the patient responsible for the difference.

  • MetLife  
  • Guardian
  • BCBS(not LA) and their sub companies: Ambetter, Anthem, Envolve, Care First, etc.
  • Unum
  • AlwaysCare/Starmount

Out-of-Network with issues

  • Humana EPO FedVip HMO– does not pay our office at all.
  • Medicaid– does not pay our office at all.
  • MetLife FedVip – some plans make the patient responsible for the difference.
  • BCBS FEP – pays the patient directly, so we will collect fee in office and patient will get the check for the insurance portion at their home.

Out-of-Network? What this means for you:

  • You can continue to receive your dental care here at our office.
  • We will still file claims for you.
  • Your insurance will still process your claims and pay estimated insurance benefits to our practice.
  • Once your insurance has been flied there could be an out of pocket expense on your account due to us being out of network
  • We appreciate your loyalty, and hope that this has only a positive impact on your dental care. 
  • We will continue to offer you the high quality dentistry you have come to expect from us and are happy to answer any questions.

KNOW YOUR INSURANCE

So that there are no surprise, make sure you know your coverages! We have prepared this web page to help you better understand the complexities of dental insurance; we realize how confusing it can be. To begin, we would like to highlight a misconception: dental insurance is not designed to pay for all of your dental care. Most contracts have yearly limits, treatment limitations and/or various degrees of “co-payments”.

All levels of payment by insurance companies, including allowed fees, usual, customary, and reasonable (UCR) are governed by the premiums paid. They have nothing to do with the actual fee for the services rendered. Our fees are based upon a combination of our costs, our time, and our consistent dedication to providing our patients with the highest quality of dental care. Thus, there is often a discrepancy between the amount covered under your policy’s UCR schedule, and the actual cost of the procedure. The discrepancy is the patient’s responsibility.

The treatment recommended by our practice is never based on what your insurance company will pay, as your oral health care and accompanying treatment should not be governed by your insurance company contract.

Thus, it should be understood that the dental insurance contract is between the insurance company and the patient. If you are unclear as to whether a particular procedure is covered by your carrier, please contact your plan documents.

We will do our best to estimate costs for you, but we know that insurance often covers differently on the back end.  It is increasingly difficult to estimate insurance these days.  With new government privacy laws, less and less information is given out on the insurance verification portals.  When we call, there is some information they will only give the PATIENT! That puts us at a disadvantage when giving out quotes. That’s why the document we present states: “Insurance coverage is only an ESTIMATE. Patient is responsible for all fee changes and services not covered by insurance.”

We hope this information has been helpful. Please take the time to review your insurance policy’s nuances thoroughly so that we may best serve you. As always, you may feel free to ask any member of our staff for clarification on services, billing and insurance.