Dental Insurance Policy
We apologize for the inconvenience, but we are not a dental provider for Medicaid and Healthy Kids at this time.
If we have received all your insurance information on the day of the appointment, we will be happy to file your claim for you. You must be familiar with your insurance benefits, since 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.
If you have not paid your balance within 60 days, a re-billing fee of 1.5% will be added to your account each month until paid. We will be glad to send a refund to you if your insurance pays us.
General Insurance Info
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. 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.
Some things to consider:
- 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% to 100% of all dental fees. This is not true! Most plans only pay between 50% to 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.
- 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.
- 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 pay 80% of $100.00, or $80.00. Out of a $150.00 fee, the company will pay an estimated $80.00, which leaves 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.