If you have insurance, we will do all we can to maximize your benefit. Dental Insurance is a contract between you, your employer, and your insurance carrier. Your dental insurance is not a contract between your insurance carrier and your doctor, unless your doctor is a provider for your insurance carrier and has contracted to a specific fee schedule with your carrier. The estimated payment for the primary policy will be due at the time of service
The reimbursement levels will vary from one insurance carrier to another. One carrier may say they pay 80% for root canal treatment (endodontics), when what they actually pay is 80% of the carrier’s fee schedule, which is usually below the actual fees for our geographic area. Insurance companies determine benefit packages and payment rates (“usual and customary” or UCR) by the plan type that is purchased by the employer/insured party – not by the level of care provided by our office. All charges, including interest, accrued from the date of services rendered, are your responsibility regardless of insurance benefits, arbitrary determination of UCR payment, or lack thereof. Factors such as deductibles, annual limits, and maximum allowable amounts per procedure may also cause differences in reimbursement.
On treatment visits, we are usually able to accept your insurance if you obtain prior approval from our office. We will have you pay your estimated portion not covered by insurance (we will determine for you). If your insurance pays more than your account balance, we will send you a refund immediately.
As a courtesy our office will file, at no cost to you, your insurance claim with your carrier at the time of service. You must provide us with accurate and complete information to properly obtain the maximum reimbursement. We will provide your carrier copies of x-rays and/or written narration on your claim should your carrier require this level of documentation. We are willing to wait up to 60 days from the date of service for payment from your carrier. After ninety (90) days, unpaid accounts will go to collections. It is therefore very important that you take an active role in following your claim with your insurance carrier.
- NON-INSURED PATIENTS: All fees are payable on the day services are rendered.