Treatment, Insurance & Financing Questions

“Will a TMJ condition ever go away by itself?” Answer: Symptoms of a TMJ problem may actually be ligament or tendon strain or muscle fatigue or spasm. If so, yes. The condition may go away by itself. But if there is real TMJ pathology, that is if there is a displaced, or “slipped” disk, or if the joint is developing arthritis, then no. The condition will not correct itself, and over time can only get worse.

“I have TMJ symptoms and my dentist recommends a nightguard. Isn’t that a good place to start?”

Answer: Close to 100% of the patients in my practice have had at least one nightguard before seeing me. Most have had several nightguards  (the record so far is 13!) and none of them were relieved of their symptoms. Again, ligament or muscle strain may possibly be helped with a nightguard. But actual joint pathology will not be corrected. Diagnosis is important!! What is the condition? Will a nightguard help or make symptoms worse? These are questions that can only be answered after a thorough history, joint imaging, sonography and examination.

“Is TMJ treatment covered under my Dental or Medical policy?”

Answer: Treatment of TMJ problems are generally not covered under dental plans, because treatment is directed toward realignment of the jaw joints and is orthopedic in nature.

“Do all insurance companies cover non-surgical treatment of the TMJ?”

Answer: The examination appointment is generally a covered benefit under most medical insurance plans. But my experience over the past 10 years is that insurance coverage is becoming less and less reliable. So, be careful. Call your insurance company and ask the following question:
“Do you cover a head, neck and facial pain exam and consultation?”

After you have had an examination and consultation, our office staff can give you additional guidelines for dealing with your insurance plan. This will include specific medical diagnostic and treatment codes for your particular situation.

 

TIP: Always ask for the name of the person you are speaking with and make a note of the date and time of the conversation. If you are not satisfied with the answers you are getting, do not be afraid to ask to speak to a Benefits Supervisor.

“I have a friend whose employer is different from mine. Her insurance company is the same one I have coverage with. Her TMJ treatment was covered by her insurance and mine is not. Why?”

Answer: There are several explanations. First of all, insurance companies offer several different plan options. Employers choose which coverages to offer their employees. Second, insurance companies not only offer their own plans, they also contract with self-insured employers to administer the employer’s health plan. The result is that although you and your friend are both insured by the same company, you have different plans. Here again, the best bet is to call your insurance company before you proceed with diagnostic or treatment services and find out what YOUR plan covers.

“Do you offer financing options for TMJ treatment?”

Answer: Yes. We offer CareCredit payment options as an alternative to consumer credit cards, cash or checks. CareCredit allows you to pay over time instead of a lump sum prior to treatment. There are no up-front costs, and no prepayment penalties. Please CLICK HERE to apply.

“Can I email Dr. Halligan with my symptoms?”

Answer: We sincerely appreciate your interest, but unfortunately Dr. Halligan cannot diagnose or treat you through email, or comment on individual health challenges. If you want to have an evaluation, please check the “Find a Member” section in the American Academy of Craniofacial Pain website (www.aacfp.org) for someone in your area who should be able to help.



Print Friendly


Share this article with a friend or colleague

  • Email
  • Google
  • Facebook
  • Twitter
  • LinkedIn
  • Delicious
  • RSS

  • Practice Opportunity

    Dentists: We are expanding our practice to better serve our patients. Are you a licensed dentist interested in joining a TMJ focused practice? To discuss the possibility of your becoming part of a special practice, drop me an email or phone me at the office.

  • Contact Us

    4320 Genesee Avenue
    Suite 207
    San Diego 92117
    858-277-3910
    858-277-3258 Fax
    drhalligan@halligantmj.com
    Click Here to Refer a Patient

  • Doctors, it's here! Dr. Halligan's new eBook will show you how to produce night guards that require far less adjustment and are much more comfortable for your patients. CLICK HERE TO LEARN MORE.

  • Click to read Dr. Halligan’s recent newsletter:

  • Recent Blog Posts

  • Patient Testimonials

    Dear Dr. Halligan & Andrea,


    It's really hard for me to put into words how thankful & blessed I am for your help & treatment for the past year. I remember how discouraged & sad I felt & I'm so happy now that I'm way better!


    My jaws are doing well & I'm still always careful of what I chew. My braces are coming off soon! You guys are always so sweet & nice. It was truely amazing having you guys as my TMJ specialists. Both of you are very encouraging & I thank you for everything you've done for me & my jaws!


    God Bless & Merry Christmas!


    Love,
    Elise W.


    Click here to read more patient testimonials