We believe that superior treatment should be financially attainable for all.
Our goal is not to let expense prevent you from benefiting from the quality of care you desire and need.
Our fees are based on the quality of the materials we use and our experience in performing your needed treatment. We do request payment at time of service. This enables our practice to provide high quality individualized care without encountering extra billing costs. Complete treatment planning with a coordination of appointments and a schedule of fees are provided for each patient. We do accept direct payment of benefits from your insurance plan, but require your portion to be paid at time of service.
In order to facilitate access to the very best health care possible, you may choose from any of the following including any combination thereof: Cash, Personal Checks, Money Order, Visa, MasterCard, Discover, or CareCredit.
Flexible finance plans are available with a choice of no interest, and extended payments, on approved credit. We are pleased to offer financing through CareCredit to our patients. CareCredit is a convenient, no initial payment, low monthly payment plan for dental treatments of $1,000 to $25,000. Offering patient financing allows us to make the smile, you’ve always wanted, affordable.
We accept most traditional insurance plans. Our office does not participate in Health Management Organizations (HMO). As a courtesy to our patients, we will file your insurance claims for each visit. The fees we charge for services are based on the procedure that is to be done. Our goal is to maximize your insurance benefits and make any remaining balance easily affordable. The fees are the same regardless of whether or not insurance is involved. We recognize that your utilization of dental insurance can contribute to your dental health. We are happy to assist you to the best of our ability with your dental insurance.
Our Office Policy Regarding Your Dental Insurance
If we have received all of your insurance information on the day of the appointment, we will be happy to file your insurance claim for you. You must be familiar with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay. By law your insurance company is required to pay each claim within 30 days of receipt. We file all insurance electronically so your insurance company will receive each claim within days of the treatment. You are responsible for any balance on your account after 30 days, whether insurance has paid or not. We will be glad to send a refund to you once insurance has paid us.
We do not file pre-determinations as that would delay treatment and jeopardize proper care; however, we assure you that we will do everything to get maximum benefits for you from your insurance carrier.
PLEASE UNDERSTAND that we file dental insurance as a courtesy to our patients. We do not have a contract with your insurance company, only you do. We are not responsible for how your insurance company handles its claims or for what benefits they pay on a claim. The financial obligation for dental treatment is between you and our office. The insurance company is responsible to you, and not to our office. We can only assist you in estimating your portion of the cost of treatment. We at no time guarantee what your insurance will or will not do with each claim. We also cannot be responsible for any errors in filing your insurance; once again we file claims as a courtesy to you.
Fact 1: No insurance pays 100% of all procedures.
Dental insurance is NOT meant to be a PAY-ALL. Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 90%-100% of all dental fees. This is not true! Most plans only pay between 50%-80% of the average total fee. Some pay more, some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage or the type of contract your employer has set up with the insurance company.
Fact 2: Benefits are not determined by our office.
Depending on the level of insurance your employer purchased, some dental services may not be covered by your insurance carrier. The range of benefits depends solely on what your employer wishes to purchase. We recognize that your utilization of dental insurance can contribute to your dental health. We are happy to assist you to the best of our ability with your dental insurance. Financial arrangements are available to assist YOU in the payment of your bill.
You may have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist’s actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist’s fee has exceeded the usual, customary, or reasonable fee (“UCR”) used by the company.
A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable or well above what most dentists in the area charge for a certain service. This can be very misleading and simply is not accurate.
Unfortunately, insurance companies imply that your dentist is “overcharging” rather than say that they are “underpaying” or that their benefits are low. In general, the less expensive insurance policy will use a lower usual, customary, or reasonable (UCR) figure.
Insurance companies set their own schedules and each company uses a different set of fees they consider allowable. These allowable fees may vary widely because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a level they call the “allowable” UCR Fee.Frequently this data can be three to five years old and these “allowable” fees are set by the insurance company so they can make a net 20%-30% profit.
Fact 3: Deductibles and co-payments must be considered.
When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary (UCR) fee, we can figure out what benefits will be paid. First a deductible (paid by you), on average $50, is subtracted, leaving $100.00. The plan then pays 80% for this particular procedure. The insurance company will then pay 80% of $100.00, or $80.00. Out of a $150.00 fee they will pay an estimated $80.00 leaving a remaining portion of $70.00 (to be paid by the patient). Of course, if the UCR is less than $150.00 or your plan pays only at 50% then the insurance benefits will also be significantly less.
MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.