Insurance doesn't cover 100% of all procedures.

Dental insurance is designed to assist in covering dental care costs. Contrary to popular belief, insurance does not typically cover 90%-100% of dental expenses. Most plans pay between 50%-80% of the average total fee, with some offering more or less coverage.

The percentage covered usually depends on how much you or your employer has paid for the insurance, or the type of contract your employer has established with the insurance company. There are countless contract options available for employers to choose from.

Our office does not determine benefits.

Insurance companies establish their own fee schedules, and each company uses a distinct set of fees considered allowable. These fees can differ significantly because each company gathers fee data from the claims they process. The insurance company then uses this information to arbitrarily determine a level they deem the "allowable" UCR Fee. Often, this data can be outdated, with the information being three to five years old, and the "allowable" fees are set by the insurance company to ensure a 20%-30% profit margin.

You might have noticed that sometimes your dental insurance reimburses you or your dentist at a lower rate than the actual fee. Insurance companies often state that the reimbursement was reduced because the dentist's fee exceeded the usual, customary, or reasonable fee (UCR) used by the company.

Such a statement implies that any fee higher than the amount paid by the insurance company is unreasonable or significantly above what most dentists in the area charge for a specific service. This can be misleading and is not necessarily true.

Regrettably, insurance companies tend to suggest that your dentist is "overcharging" instead of admitting that they are "underpaying" or providing low benefits. Generally, less expensive insurance policies use a lower usual, customary, or reasonable (UCR) figure.

Yes! At Tiny Tooth Co., we accept all PPO dental insurance plans and proudly care for families both in-network and out-of-network.

We are in-network with select insurance providers, and for all other PPO plans, we help you maximize your out-of-network benefits—without compromising the quality of your child’s care.

As a courtesy, our team will:
• Verify your child’s insurance benefits in advance
• Submit claims on your behalf after each visit
• Provide a clear estimate of your expected out-of-pocket investment

We always recommend contacting your insurance provider directly to better understand your specific plan, coverage, and network details.

At Tiny Tooth Co., our priority is simple: we work for your child—not the insurance company.
This means our treatment recommendations are based on what is best for your child’s health, growth, and long-term development—not insurance limitations.

While we’re here to support you every step of the way, please note:
Insurance companies determine coverage, reimbursements, and claim decisions. Our estimates are based on the information available at the time and are not a guarantee of payment.

If you have any questions about your coverage or need help understanding your benefits, our patient experience team is always here to guide you.

We Accept All PPO Dental Insurance . We work for your child—not your insurance company.

We proudly accept a variety of in-network PPO insurance plans, including Aetna, Ameritas, Blue Shield of CA. Anthem Blue Cross of CA (excluding the Pediatric plan), BEAM, Principal, SunLife, United Healthcare/UHC, Cigna DPPO (excluding the Advantage plan), Pacific Life Dental, Humana, and more.

For those with out-of-network insurance, upfront payments are required. As a courtesy, our team will submit claims on your behalf and run a pre-estimate benefits check to determine your out-of-network coverage. Your insurance will reimburse you directly based on your plan's coverage.

Please note, we are not your insurance company and cannot guarantee reimbursements. We provide the information available to us, but it is not a guarantee. It is your responsibility to know your coverage details, including the end date and reimbursement specifics.

For more information or questions, please contact our office or your insurance carrier.

At Tiny Tooth Co., we proudly accept ALL PPO insurances to ensure your child gets top-quality dental care. We complete a courtesy pre-estimate for every patient, submitting all necessary information to your insurance provider. While we do our best to help you navigate the process, please note that the relationship between your insurance company and you, the subscriber, ultimately determines coverage and reimbursement.

We require payment upfront for services, but your insurance provider will reimburse you directly based on your plan’s benefits. For out-of-network patients, some plans may cover 100% of preventive care costs or a portion of treatment.

If you have any questions about your coverage, we encourage you to contact your insurance provider directly, as they will have the most accurate and up-to-date information about your benefits. At Tiny Tooth Co., we are always here to assist you as best as we can, but insurance coverage is ultimately between you and your provider.

We strive to make dental care as simple and accessible as possible, so you can focus on your child’s smile!

At Tiny Tooth Co., we do not accept HMO or Denti-Cal (Medi-Cal) plans. These insurance plans often place limitations on treatment options, appointment time, and materials, which can impact the quality of pediatric dental care.

We are a pediatric dental practice focused on delivering personalized, high-quality care without insurance-driven restrictions. For families with HMO or Denti-Cal, we offer a one-time New Patient Special to provide a smooth, stress-free first visit—please call our team for details. In additional, we offer our Smile Squad Membership Plan offers preventive dental care, exclusive savings, and predictable pricing—without the limitations of insurance.

Our goal is to provide comprehensive, prevention-focused pediatric dentistry with transparency, comfort, and exceptional clinical care for every child.

Say goodbye to insurance nightmares! We're thrilled to introduce our exclusive in-house dental insurance plan, crafted with families in mind. We're kicking the middleman to the curb to bring you affordability and unbeatable benefits. Enroll your child today, and they'll be treated to the VIP dental experience – think two yearly cleanings, two exams, two fluoride applications, 24/7 access to our providers, routine x-rays as needed, plus a fantastic 20% off on all our dental services excluding indirect pulp caps, nitrous oxide, and silver diamine fluoride, and ortho clear aligners. It's not just coverage; it's a dental delight!

Our membership plan is not (i) insurance, (ii) a qualified health plan under the Affordable Care Act, (iii) pre-payment for future services, or (iv) payment for access to discounted services. Rather, our membership plan is a direct payment arrangement for services, products and care provided. The membership plan includes a 30-day money back guarantee. You can receive a full refund up to 30 days after purchase if no services or discounts have been used. We have partnered with Kleer, LLC to provide our membership plan to you. Kleer is located at 676 East Swedesford Road, Suite 350A, Wayne, PA 19087. You can learn more about Kleer at kleer.com. Your payments must be current to receive the services and discounts included in the membership plan. Payment for treatment not included in the membership plan is due at the time of service. The membership plan benefits may not be combined with insurance or any other offers or discounts. Our membership plan does not cover procedures completed by specialists outside our practice. The membership plan runs for 12 months and includes an auto renewal feature. You can opt out of the auto renewal at anytime from the Member Portal. You will receive an email reminder 45 days prior to the renewal date

Unless other arrangements have been made beforehand, full payment is required at the time of treatment. To make this process more convenient, we accept all major credit cards (Apple Pay, Visa, MasterCard, American Express, and Discover Card) as well as cash payments. Additionally, our patient care coordinators can help you with tailored plans through our financing alternatives. Please don't hesitate to reach out to us.