If you have dental insurance to help cut the cost of your dental care, our staff is happy to help you obtain the maximum use of these benefits. Knowing this, please read the information on our insurance claims process, so that we can work together to ensure this benefit.
Do you accept my insurance? How much will they pay?
We accept most private insurance plans and currently work with hundreds of insurance companies. Although we maintain computerized histories of payments by many insurance companies, these payment rates do change, therefore, it is impossible for us to give you a guaranteed quote at the time of service. We will ESTIMATE your portion based on the most up-to-date information we have, but this is only an estimate.
I thought I paid my portion, but I still received a bill. Why?
We collect your ESTIMATED portion at the time of service, but that estimate is only as good as our most current insurance data. There are several factors that can affect this estimate. For example, there may be a deductible, or you may have received treatment in another office prior to joining our office. Insurance companies do not inform us of any changes to your benefits. We do, however, investigate your benefits as thoroughly as possible.
My insurance did not pay, Why?
We bill your insurance as a courtesy, however, your dental insurance is a contract between you and your insurance company (or between your employer and the insurance company). Since we are not a party to that contract, we cannot explain why your insurance company did or did not pay for a specific procedure. The extent of coverage varies greatly from company to company, and from one plan to another. The level of benefit you receive is determined by the contract you (or your employer) signed up for. The premium you pay, amount of deductible, co-pay amounts, and annual maximums are all terms of that contract. It has absolutely nothing to do with the level of service that we provide, or the fee charged for these services. An often misunderstood term used by many insurance companies is “UCR”. This is an arbitrary fee “ceiling”, created by the insurance company, beyond which there is no benefit. These fee ceilings were often set 10-15 years ago, so are not compatible with dental fees charged today. Despite our best efforts to give you an accurate estimate, a patient will occasionally owe a difference. Again, this has nothing to do with the fee charged, but the level of coverage negotiated with your insurance company.