We work with many different insurance plans. However, your insurance may require you to see a specific dentist in order to receive maximum benefits. Please check the information provided by your employer or insurance company to make sure you will receive benefits for treatment in our practice.
While many people think their dental insurance "covers everything," most plans have some restrictions – either in the amount they pay or in the services "covered." Since our offices work with hundreds of insurance plans, it is impossible for our team members to know the details of your plan. We have no control over how much of our fees or which services are covered by your plan. Since your plan coverage and benefits are contracted between you, your employer and the insurance company, it is your responsibility to know your plan. Please understand that we cannot, as a third party, become involved in insurance negotiations. This is your responsibility.
Our doctors' treatment recommendations are based on what they believe is in your child's best interest rather than on what your insurance covers.
If your child needs treatment other than routine/preventive care, we will give you a written fee estimate. This allows you to contact your insurance company to determine your benefits. If the estimated fee is more than $500.00, we will file a predetermination-of-benefits form for you.
As a courtesy, we file your insurance claims and make every effort to help you with your insurance. However, you are responsible for any fees not paid by your insurance as well as keeping us informed of any insurance changes, such as policy name, insurance company address or a change of employment.
Facts you should know about dental insurance:
Fact #1: You may receive a letter from your insurance company stating that our fees are higher than "usual or customary." An insurance company surveys a geographic area, calculates an average fee and then takes 90 percent of that fee and considers it "usual and customary." Since these are average fees, some practices or clinics may have fees lower than this "usual or customary" fee, and some doctors have fees higher than the "usual and customary" fees.
Fact #2: Dental insurance is not meant to pay ALL your dental fees. It is only meant to help you with these costs.
Fact #3: Many routine dental services are NOT covered by some insurance plans.
Fact #4: Many plans tell their insured that they will be covered "up to 80 percent" or "up to 100 percent" but do not clearly specify that the plan has a fee schedule allowance, an annual maximum or other limitations. We have found that most plans cover about 35-65 percent of services based on the plan's maximum fee allowance.
Fact #5: The amount your plan pays is determined by the particular plan purchased by your employer. Generally, the less the plan costs the employer, the less you receive in benefits; only your employer can adjust benefits or change policies.
Fact #6: As your dental care provider, our relationship is with you and your child, not your insurance company. While the filing of insurance claims is a courtesy we provide to our patients, all charges are your responsibility.
We want you to be comfortable dealing with these matters, and we encourage you to ask us if you have any questions regarding our services and/or fees. We will do all we can to help you receive the maximum benefits from your insurance.
If you have any questions about specific procedures covered in your plan, please contact your company's benefits manager.
Payment of Fees
Once the doctor has completed your child's examination, you will be given an estimate of the total fee for any recommended treatment.
If you choose to pay for your child's treatment at each visit, we offer a 5% savings for payment with cash, check, money order or credit card. Otherwise, all accounts are due within 30 days from the date of service. For your convenience, we accept MasterCard, Visa, American Express, and Discover credit cards. We also offer a low- and no-interest financing option through the CareCredit system.
If you have any questions about financing or payment, please ask us! We will thoroughly explain your choices and work hard to accommodate your needs.