|
Payment Policies
/ Facts about Insurance
Notice of Privacy Practices
Office
Hours
Monday
through Friday --- 8:00 AM - 5:00 PM
Payment
Policies
Payment
is requested at each office visit. If you have dental insurance, as
a courtesy we will file your insurance for you. We work with almost
all traditional plans (a plan that allows you to choose any dentist) and
several PPO and PDP plans. We accept Visa, MasterCard, American
Express, Discover, personal checks, or cash. You can also pay for
your treatment through Care Credit
or Dental Fee Plan, third party finance
companies.
We
will file your insurance at no charge and we will make every effort to
assure you receive maximum benefits. In order to provide this
service, we will need your updated insurance information before each
appointment.
Please
do not hesitate to ask questions about our financial policy. We want
you to be comfortable in dealing with these matters. If you have any
questions regarding your insurance, we ask that you contact your company
regarding the specifics and details of your plan.
We Accept:
Back
to Top
Facts
About Insurance
Fact
1 - NO INSURANCE PAYS 100% OF ALL PROCEDURES
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.
Insurance
companies will not release the exact amount they will pay for a procedure
until the treatment is completed and the claim is submitted. They
will only state the percentage of their fee schedule that they will cover.
Fact 2 - BENEFITS ARE NOT DETERMINED BY OUR OFFICE
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.
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. Our fees are within range of other dental offices in the
area.
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.
Fact 3 - DEDUCTIBLES & 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.
Back
to Top
|
