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Navigating the World of Dental Insurance Terminology

May 16th, 2023

Unless you work for an insurance company, you probably do not spend a lot of your time studying all the terminology that dental insurance companies use to describe the treatments and services they cover. If it seems pretty confusing, here are some of the most commonly used dental insurance terms and what they mean.

A Basic Glossary

Annual Maximum–The maximum amount your policy will pay per year for care at South Hill Pediatric Dentistry. It is often divided into costs per individual, and (if you are on a family plan) per family

Co-payment– An amount the patient pays at the time of service before receiving care, and before the insurance pays for any portion of the care

Covered Services– A list of all the treatments, services, and procedures the insurance policy will cover under your contract

Deductible– A dollar amount that you must pay out of pocket each year before the insurance company will pay for any treatments or procedures

Diagnostic/Preventive Services– A category of treatments or procedures that most insurance will cover before the deductible which may include services like preventive appointments with Drs. Coombs, Holmes, and Johnson, X-rays, and evaluations

In-Network and Out-of-Network– A list of providers that are part of an insurance company’s “network”

  • If you visit in-network providers, the insurance company will typically cover a larger portion of the cost of the care you receive. If you visit someone who is not part of the network, known as an out-of-network provider, the insurance company may pay for a portion of the care, but you will pay a significantly larger share from your own pocket.

Lifetime Maximum– The maximum amount that an insurance plan will pay toward care for an individual or family (if you have an applicable family plan)

  • This is not a per-year maximum, but rather a maximum that can be paid over the entire life of the patient.

Limitations/Exclusions– A list of all the procedures an insurance policy does not cover

  • Coverage may limit the timing or frequency of a specific treatment or procedure (only covering a certain number within a calendar year), or may exclude some treatments entirely. Knowing the limitations and exclusions of a policy is very important.

Member/Insured/Covered Person/Beneficiary/Enrollee– Someone who is eligible to receive benefits under an insurance plan

Provider– Drs. Coombs, Holmes, and Johnson or other oral health specialist who provides treatment

Waiting Period– A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments; waiting periods may be waived if you were previously enrolled in another dental insurance plan with a different carrier

There are many different insurance options available, so you need to find out exactly what your insurance covers. It’s important to review your plan with a qualified insurance specialist. Don’t be afraid to ask questions about the policy so you can understand it fully and be confident that you know everything your policy covers the next time you come in for treatment at our Spokane, WA office.

May Marks National Physical Fitness and Sports Month!

May 2nd, 2023

The merry month of May also happens to be National Fitness and Sports Month, so take advantage of the warmer days to get outside and exercise! Bringing a friend, family member, or coworker with you when you go for a brisk walk during a lunch break can provide an opportunity to socialize as well as health benefits. If you need a little more motivation, here are some good reasons to stay active and fit.

Exercise provides:

  • Improved stamina and energy as well as toned muscles and bone strength and density
  • Improved circulation and breathing for a healthier heart and lungs
  • Reduced risk for Type 2 diabetes and certain forms of cancer
  • For older adults, regular exercise may help improve balance and reduce the risk of falls as well as improved cognitive abilities

Children and Teens

Children and teenagers spend long hours at their desks in school, on the computer, watching television, and involved in other sedentary activities that result in obesity and poor health later in life. Getting them engaged in school or community sports teams can help them form good life-long exercise habits. One important note: If they are participating in contact sports, Drs. Coombs, Holmes, and Johnson and our team at South Hill Pediatric Dentistry recommend your kids wear an approved mouthguard to protect those valuable teeth from injury! Ask us for a proper fitting of your safety appliance during your next visit!

A gym membership is nice but not necessary to stay fit; try these easy ways to work some exercise into your daily routine.

At Home

  • Take a friend along for company on a walk through your neighborhood.
  • Pursue gardening or other yard work, including mowing or raking.
  • Take your kids on a bike ride or have them push a baby stroller around the block.

Couch potatoes take note: simply moving from the sofa to the floor for some sit-ups, leg-lifts, or push-ups while you’re watching television can help you get in better shape in no time.

At Work

  • Take the stairs instead of the elevator.
  • Take exercise breaks for walks around the building or parking lot.
  • Walk or ride a bike to work.

So what are you waiting for? Get moving!

For more information on exercise techniques, or to schedule an appointment with Drs. Coombs, Holmes, and Johnson, please give us a call at our convenient Spokane, WA office!

Pediatric Dentistry Q&A

April 25th, 2023

Today, Drs. Coombs, Holmes, and Johnson and our team at South Hill Pediatric Dentistry thought we would answer some of the most frequent questions about pediatric dentistry and oral health we hear from parents.

What constitutes a “healthy, balanced diet” for my child?

A healthy, balanced diet contains all the nutrients your child needs to grow, including one serving each of fruits and vegetables, breads and cereals, milk and dairy products, and meat, fish and eggs per day. Make sure your child limits snacking in between meals and limits how frequently they consume food or beverages that contain sugar, which is known to cause tooth decay. Besides pastries, cookies, and candy, sugars are usually found in processed foods such as crackers, cereals, and soda, as well as in condiments like ketchup.

Should my kid give up all foods that contain sugar?

Absolutely not, we simply recommend choosing and serving sugars sparingly. A food with sugar is safer for teeth if it is eaten with a meal, not as a snack. When your child chews during his or her meal, the saliva produced helps neutralize the acids that are found in sugary and starchy foods. Foods that are not easily washed away from your child’s teeth by saliva, water, or milk have more cavity-causing potential.

What causes cavities?

Many types of bacteria live in our mouths—some good, some bad. When these bacteria come into contact with sugary foods left behind on your child’s teeth after eating, acids are produced. These acids then attack the enamel, and eventually eat through the enamel and create holes in the teeth, which Drs. Coombs, Holmes, and Johnson and our team call cavities, or caries.

How can I help my child avoid cavities?

This is a great question that we hear a lot. Make sure that your child brushes his teeth twice a day with fluoride toothpaste. Flossing daily is also important, as flossing can reach spots between the teeth that brushing simply can’t. And finally, we encourage you to schedule regular appointments with Drs. Coombs, Holmes, and Johnson at our Spokane, WA office so that we can check the state of your child’s teeth and gums, as well as provide a professional cleaning to protect him or her from cavities and gum disease.

What is the best way to clean my baby’s teeth?

We recommend you clean your baby’s gums after feedings with a damp, soft washcloth. This is even before your baby’s first tooth appears. As soon as his or her first tooth does appear, you may begin using a toothbrush with soft bristles and a small head. You can most likely find a toothbrush designed for infants at your local drugstore or ask us for one during your next visit.

What should I do if my child has a toothache?

First, we recommend rinsing the irritated area with warm salt water and placing a cold compress on his or her face if it is swollen. If you have any at home, give your child acetaminophen for any pain, rather than placing aspirin on the affected teeth or gums. Finally, give us a call as soon as possible to schedule an appointment with Drs. Coombs, Holmes, and Johnson.

We hope that helps! Please give us a call if you have any questions or ask us next time you visit our office for your child’s appointment with Drs. Coombs, Holmes, and Johnson! If you have any other questions, or would like to schedule an appointment, we would love to hear from you.

Every Day is Earth Day

April 25th, 2023

During the early days of the environmental awareness movement, those who demonstrated against pollution, toxic chemicals, and the general public health were known as hippies. The early 1970s were a time of change, and assertions that we needed to pay more attention to the Earth's atmosphere were generally dismissed. But within a couple decades, it had become clear that the previous generation was right; the citizens of the world needed to become more environmentally conscious.

Many people feel that they can't make a difference if they don't do something big. But caring for the environment doesn't have to be an all-or-nothing concept. In fact, the little things you do can add up to make a great impact, especially in our community. Here are a few ways you can help the environment on Earth Day, April 22nd and all year around.

Four Small Ways to be Environmentally Friendly

  • Recycle Your Textiles. Nearly 21 million tons of textiles are added to American landfills each year, according to the Environmental Protection Agency. Donating your unwanted clothing to a secondhand store or an organization that repurposes fabric helps cut down on solid waste and conserves natural resources.
  • Reduce Usage of Disposables. Plastic bottles and bags, disposable diapers and other things we can use and toss out are convenient, but they're not necessary. Simply choosing to replace one of type of disposable with a reusable product can help you cut down on waste that has a large negative impact on our environment.
  • Conserve Water. If everyone in the United States turned off the water while brushing their teeth, more than 1.5 million gallons of water could be conserved. Turn the water on long enough to wet your toothbrush for brushing and rinsing, and then immediately turn the water off again.
  • Turn Off the Lights. Flip the light switch to "Off" if you're going to leave a particular room for 15 minutes or more. This will conserve energy on incandescent light bulbs and cut down on cooling costs.

It's not necessary to be an activist or install solar panels all over your home to help the environment. Although you can do these things, the little everyday measures make a big difference in helping to conserve energy and the environment, while reducing your carbon footprint. Our team at South Hill Pediatric Dentistry wants to remind you to celebrate Earth Day and help the environment, knowing that it will benefit your and your children's generation.

611 E 31st Ave
Spokane, Wa 99203
(509) 315-8500