What type of insurance is accepted ? Are you a “network dentist”?
We are currently “In Network” with Delta Dental Premier, if your Dental Insurance is a PPO plan with out of network benefits, our off will balance bill for treatment. A good PPO plan will cover 90% of our fees leaving a balance of $20-$30 dollars for cleaning, exam, and X-rays. We do not participate in any EPO, HMO or DMO plans or discount insurance cards.
Do you file dental claims or am I responsible for the filing?
We will be happy to assist you in filing your dental claim. Our office files dental claims electronically. The electronic claims systems require current patient information including the member’s birth date, employer, social security number and insurance claim address.
What do I pay at the time of my appointment?
In an effort to maintain a high quality of patient care, the total amount or the amount not covered by insurance is due at the time of treatment. Our office will do everything possible to prepare the patient for his/her appointment and get the most coverage from your dental insurance. However, in the event that insurance does not pay or is delinquent in payment, the patient is responsible for the account balance. Account balances can be paid by cash, check or Visa, Master Card, America Express, and Discover. For dental patients want to finance treatment, CareCredit.com is a good option.
Good dental insurance covers 90% – 100% of preventative (cleanings, exams, x-rays). Coverage varies with each insurance policy Insurance companies normally cover 50% – 80% of restorative (fillings, crowns, bridges) . For treatments considered extensive, a pretreatment authorization can be submitted to confirm benefits. If your insurance carrier requires a pretreatment authorization for restorative work, please notify the office with each necessary request.
What does usual and customary mean?
Insurance companies determine their fee allowances by surveying a geographic area. They average the fees and take 70% – 90% of that number to determine their usual and customary fee allowance. Included in the fee survey are discount clinics that reduce the average. Most dentist will have fees that are considered above usual and customary. It has been our experience that insurance companies will freely tell the insured that fees are “above usual and customary” rather than saying “our dental benefit allowances are below average.” Also, please remember that most insurance companies are dictated payment allowances by the actual business organization they represent.
Proudly serving the Littleton, Centennial, Englewood and Highlands Ranch communities.