IS DTR THERAPY COVERED BY INSURANCE?
No. The devil is in the details:
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People assume insurance exists to protect them from expensive bills. Dental plans do the exact opposite by prioritizing predictable, low‑cost payouts and ADMINISTRATIVE CONTROL.
The gap between expectation and design is where insurers exploit your confusion. Opaque EOBs and fee schedules, low annual premiums, waiting periods, shifting denials, vague reasoning, complex coding, low reimbursements, and retroactive audits are all tactics that benefit the insurance company while exploiting the good-willed ignorance of patients and doctors alike. ​Dental insurance often caps benefits, excludes many common procedures, and shifts costs to patients while collecting steady premiums. The mismatch between what people expect and what plans actually pay is a common root of frustration. Major procedures quickly exhaust benefits, leaving large bills. Many patients pay more in premiums than they ever receive in benefits.
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Dental insurance companies act in bad faith by handling claims or policyholder interactions in ways that are unfair, deceptive, or contrary to the insurer’s duty to act reasonably and in good faith. Common legal examples include unreasonable denials, unjustified delays, misrepresenting policy terms, and failing to investigate claims properly. Lack of reasonable explanations, repeated stonewalling, inconsistent reasoning, and refusal to provide basis for denials are common tactics. Limited coverage, waiting periods, and exclusions typically end up translating into financial surprises at the chair, such as expected treatments being denied, upcoded, or presented with a long list of "nickel & dime" fees.
"In-network" dentists are constrained from delivering high quality care by complex rules regarding fee schedules, participation discounts, and preauthorizations. ​Insurance contracts set allowed amounts for procedures, so when lab or material costs exceeds the allowed fee, practices either absorb the loss or choose lower‑cost materials/labs to keep margins. This can subtly shift choices toward less expensive crowns, implants, or restorative materials. Most dentists maintain clinical standards, yet when reimbursement is tight, an "in-network" practice may favor treatments and billing that fit the fee structure rather than the absolute clinical ideal. Higher patient volume and lower per‑visit revenue push practices to increase throughput: quicker exams, more delegated tasks to auxiliaries, and tighter scheduling. The "in-network" business model reduces time for patient Q&As, affects work quality, and limits complex case planning. Because insurers reimburse certain codes more predictably, "in-network" practices may present those options first, shifting patient choices by framing out‑of‑network or premium options as “cosmetic” or “not covered.”
Insurers unfairly use language, paperwork, and process to shift blame onto out‑of‑network dentists (portraying them as greedy, deceptive, or noncompliant) while the real drivers are plan design, low reimbursements, and administrative controls. They use patient‑facing copy that normalizes "in‑network" care and subtly paints out‑of‑network providers as exceptions or problems. That language primes patients to distrust a dentist who isn’t “in network.” This is effective because most patients assume insurance equals endorsement. EOBs show an “allowed amount,” insurer discount, and a patient balance without clearly tying those numbers to the dentist’s estimate. Patients see a big balance and often assume the dentist overcharged rather than that the insurer paid less than the dentist’s fee. This confusion discourages patients from questioning insurer reductions. Customer service scripts and online provider finders emphasize "in‑network" options and may present out‑of‑network care as risky or expensive, even when the real issue is low "in‑network" reimbursement. That steers patients away and makes independent dentists look like the problem. Insurers deny or reduce claims citing coding, “not medically necessary,” or missing documentation. When reasons shift or are vague, patients and small practices lack the resources to push back, so the dentist appears to be at fault. After paying a claim, insurers sometimes audit and recoup payments or reclassify services. Publicizing audits or recoupments frames the dentist as having billed improperly, even when the issue is a narrow interpretation of plan rules. Insurers can present directories or search results that minimize out‑of‑network options, then claim access problems are the dentist’s fault rather than a network design choice. This reinforces the narrative that only in‑network care is “safe” or “approved.”​
WHAT IS YOUR DTR SUCCESS RATE?
The word “success” might imply a permanent absence of symptoms after DTR THERAPY. Unfortunately, this is not the nature of malocclusion or muscle hypertonia. In fact, there cannot & should not be any guarantee of a “cure” given by any DTR-certified dentist. ​A “success rate” is subjective at best (and possibly baseless at worst). At your 3-hour diagnostic appointment, you will learn much more about the nature of your symptoms and why “success rate” claims can be misleading. DTR THERAPY is a not a “cure”, but rather a “calibration”.
If the question behind your question is something along the lines of experience and/or trust, a thorough scrutiny of our website should suffice for you to make that judgment call for yourself. Our “professional resources” page is specifically intended to address questions, concerns, and criticisms from dentists, patients, and physicians alike. You should find the information there (discussion videos, literature articles, and elaboration) helpful.
Dr. Harden prefers to let our patients speak for themselves via our youtube website - Jeffrey Harden, DDS - YouTube. We continue to add more videos with each patient who is willing to allow us to share their story. M​any of the symptoms of temporomandibular disorders overlap each other, especially for patients whose condition is related to dental malocclusion. Of course, there have been many more patients who are not comfortable sharing their likeness & story on the internet, which is completely understandable & we respect their privacy, as we do yours.
