What about finances?
We strive for excellence in all facets of our business, and are committed to developing flexible payment plans that facilitate your child’s treatment needs. Payment for professional services is due at the time dental treatment is provided. Every effort will be made to provide a treatment plan which fits your timetable and budget, and gives your child the best possible care. We accept cash, personal checks, debit cards and most major credit cards.
Dental Insurance Policy:
We do ask that you provide all insurance prior to your appointment. Upon verification of your dental coverage, we offer the courtesy of filing your dental insurance. Our office accepts assignment from most types of dental insurance plans except BCBS. If we cannot verify your insurance prior to or on the day of your appointment you may be asked to pay for your services using our UCR fees (link here). We can assist you in seeking reimbursement once all insurance information is found. SEE BELOW FOR DENTAL INSURANCE FAQ's
In Network
As with most specialists, we are not a DMO/HMO provider for any insurer. Any amount not covered by your dental plan, deductibles, or co-insurance will be collected at the time of service. SEE BELOW FOR DENTAL INSURANCE FAQ's
Our Office Policy Regarding Dental Insurance
It is important that you understand that as your dental care provider, our relationship is with you, not your insurance company. The range of benefits depends solely on what your employer wishes to purchase. Insurance benefits also may vary with the age of the child. Please verify eligibility and benefits before your appointment.
We will give you an estimated payment amount which is to be paid on the day of service. Most carriers have an 80/20 plan, and that is how we estimate your payment. It is only an estimate.
For preventive visits, we may not collect a co-payment unless you know your policy does not cover this visit at 100%, as that is what we base our estimated portion on for this type of visit. For operative appointments, we require that you make payment of your estimated portion AT TIME OF SERVICE. This is just an estimate on our part, and true payment will not be known until the claim is submitted and payment is received.
Our fees are considered to fall within the acceptable range of most companies. However, some carriers use an arbitrary fee schedule, which bears no relationship to the current standard and cost of care in this area. The range of benefits depends solely on what your employer wishes to offer his/her employees. SEE BELOW FOR DENTAL INSURANCE FAQ's
If for any reason, we have not received your insurance carrier’s payment 60 days after the claim, the remaining balance will be due and payable by you.
The parent or guardian who brings the child to our office is responsible for payment in full. All statements will be sent to this individual. We will not bill a third party other than insurance companies.
Although we cannot guarantee payment, we are happy to obtain, at your request, a treatment predetermination to help identify plan limitations and/or exclusions as a means to better estimate your out-of-pocket expenses. This dental pre-determination estimate may take 4-6 weeks to be returned to our office. You may also log onto your carriers website and obtain your estimated benefits. Just remember, this is still an estimate, not a guarantee of payment or coverage.
Some Facts about Dental Insurance:
Fact #1: Benefits are not determined by our office - Insurance is a contract between you and your insurance company. Your insurance benefits are determined by the type and design of the plan chosen by your employer. Limitations established by your insurance company are negotiated by your employer and reflect the quality of the insurance product purchased.
We have no control over the terms of your contract, the method of reimbursement, or the determination of your benefits. Your insurance company can define some and perhaps all of the services as “not covered,” “denied,” or “over UCR.”
Insurance companies may state that the reimbursement was reduced because “your dentist's fee has exceeded the usual, customary, or reasonable fee (UCR)”. This statement gives the impression that the dentist’s fee is unreasonable. This is misleading and inaccurate. Some insurance companies may imply that your dentist is overcharging, but in reality they may be underpaying or providing a low benefit.
Insurance companies set their own fee schedules, and each company uses a different set of fees. Frequently, this data can be up to 5 years old and setup for increased insurance profitability.
Fact 2: No insurance pays 100% - The amount of coverage you receive depends on dollars spent by your employer, not the fees of the doctor. As a rule, most insurance companies only cover between 50% and 70% of usual and customary fees.
Fact 3: Our office knows all the limitations of your plan - Unfortunately due to the thousands of different plan types and the limited information that is shared with us by insurance companies we ask that YOU please be familiar with YOUR insurance benefits so that you may help make informed decisions regarding treatment before arriving for your appointment. This also helps to avoid any potential "surprises" on coverages or frequency limitations.
PLEASE UNDERSTAND that we file dental insurance as a courtesy. We are not responsible for how they handle claims. We can only assist in estimating. Our team will strive for accuracy in billing your insurance as long as we have all necessary and accurate information from you to do so. Our team is not responsible for any errors in filing your insurance.