Dental care can be expensive, especially if you don’t have insurance. Using this free dental cost calculator can help you better understand your costs and plan ahead for procedures.
Dental policies typically have annual maximums, copays, waiting periods and other factors that impact their cost. Learn more about how the calculation works here.
How to use the calculator
As a dental front desk team, you likely spend a lot of time calculating patients’ out-of-pocket costs. But sometimes the math is confusing and it can be easy to get things wrong. Whether you’re using dental software or not, knowing the “why” behind the numbers can help you avoid common mistakes.
For example, if a patient needs a filling that costs $100 and their insurance covers 80%, they’re responsible for 20% of the cost. But if they go to a dentist who isn’t in their network, the cost could be more than they expect. The calculator helps to simplify that calculation for your employees by subtracting both the out-of-pocket costs and the percentage their plan pays.
The version of the calculator that’s available to anyone (without a sign-in) uses procedure costs or cost ranges as reflected in provider fee schedules and aggregated historical cost data. It also may use information that providers have submitted for claims and treatment categories, which are not a recommendation of any particular procedure or a recommendation that a patient obtain any particular treatment. The version of the calculator that requires a sign-in uses similar information but also takes into account individual dental circumstances and decisions made by patients in consultation with their dental care professionals.
Procedures
Dental costs can vary widely from office to office, as well as from area to area. It’s not surprising considering the fact that each procedure is a unique service and requires a different set of supplies and equipment. Some procedures have a fixed cost, such as a cleaning and exam, while others may be subject to an hourly rate depending on the complexity of the task at hand.
A root canal is a much more involved procedure than a filling, so it is understandable that it would incur higher charges. In addition, a crown is required for a root canal, so the overall price tag of this procedure can increase significantly. This is also true for more complex cosmetic procedures like veneers and teeth whitening.
Regardless of the type of work being performed, a dental insurance deductible must be met before coverage begins to apply from a plan’s benefits. This amount varies from plan to plan, and it can also change depending on the type of work being done or whether it is in-network or out-of-network.
It is important to properly communicate these costs with your patients to avoid confusion and reduce frustration. This will help keep them happy and ensure your team is doing their best to maximize their dental benefits. By properly educating patients on how their coverage works, the math behind downgraded fees and why certain procedures are more expensive than others, your front desk will have happier and more loyal patients.
Materials
Many dental practices calculate their gross profit margin using a simple formula that doesn’t include the cost of materials. For example, a patient comes in with a toothache and needs a filling. Their insurance covers 80% of the cost, leaving them to pay 20%. Rather than simply multiplying the lab fee by 20% to establish their office fee, this calculator allows dentists to take into account the actual cost of the material. This helps ensure that profit is planned for and that workflows can be optimized accordingly, according to Ivoclar.
When comparing costs between different dental offices, it’s important to understand exactly what each one is quoting. For example, a dental crown might be quoted as gold, porcelain-fused-to-base-metal, or all-ceramic, and each of these may have substantially different costs. This is why a COA (cost of operation) sample is so useful in determining true cost differences between dental offices.
Ramp’s free dental valuation calculator and article provide an estimate of value for a practice using the most material quantifiable factors, but additional qualitative considerations should be taken into account as well. Learn how Ramp’s software can help dental businesses of all sizes — from private practices to DSOs – control spend, automate busywork, and save an average of 3.5%.
Insurance
Dental insurance can be an incredibly complex topic. Front desk teams struggle with the amount of information that is needed to correctly calculate a patient’s out-of-pocket costs, and relying on software alone can be misleading.
Dental fees are determined by a dentist’s unique fee schedule and based on factors like local labor costs, material and laboratory fees. This schedule is used to create a “usual, customary and reasonable” (UCR) charge for each procedure. The UCR is then adjusted based on the cost of living in a given area, and other factors like number of appointments, time required, and treatment category are also taken into consideration.
In addition to these determining factors, most dental insurance policies come with a variety of coverage limits and restrictions that can add to the total cost of treatment. Some examples include deductibles, co-insurance and annual maximums.
Most dental insurance plans have a yearly deductible that must be paid by the patient before the plan starts to pay for services. Once the deductible is met, the negotiated co-insurance percentage takes effect. For example, if the negotiated rate for a particular procedure is $100, the patient will be responsible for paying 20% of the cost once they meet their deductible.
Some dental plans use a network of providers to help reduce the cost for their members. These are known as DPPO, or Preferred Provider Organization, dental plans. Other types of dental insurance are fee-for-service, or traditional indemnity, plans that do not have a provider network.