Insurance Information
Our Office Policy Regarding Dental Insurance
- Prior to treatment we do require a copy of your insurance and ID. This includes any secondary insurance you wish to have billed.
- Please let us know as soon as possible about any changes in your insurance coverage. This helps us give you accurate information about your benefits and potential cost for treatment.
- We file dental insurance as a courtesy to our patients.
- We will file claims typically the same day or within 48 hours of the date of service.
- Unfortunately, we cannot be responsible for how your insurance company handles its claims or for what benefits they pay on a claim. We do our best to estimate the cost to you and provide all necessary information that will be required by your insurance company to process the claim. But your insurance company is the final determiner of benefits and coverage.
No Private 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 unfortunately is not true. Most plans only pay between 50%-80% of the average total fee. The percentage paid is dictated by your insurance company. Treatment plans will estimate your out-of-pocket expense and the benefits that your insurance company typically applies.
Benefits Are Not Determined By Our Office
Every insurance plan has a contracted fee schedule that dictates how much the clinic can be reimbursed for all procedures. This varies greatly from insurance to insurance and plan to plan. If you have insurance the clinic does not decide how much you will pay for services, your insurance does. We can provide an estimate based on what your insurance will cover and the fees they decide the patient will pay and the clinic will receive.
Deductibles Are Not Determined By Our Office
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 $50.00, 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.
Insurance & Payment Options
We accept most major insurance carriers and we offer financing through Cherry and CareCredit, allowing you to make convenient monthly payments towards your treatment plan. Call today for more information 541-686-1199.
