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Insurance FAQs Click
a subject for details: What type of insurance is accepted? In order to provide the highest level of dental care, we contract with the patient - not the dental insurance company. This means that our office does not "sign-up" with any insurance plan. We welcome all new patients and encourage you to contact your insurance carrier to verify eligibility prior to your visit. Top 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 birthdate, employer, social security number and insurance claim address. Top 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. However, in the event that insurance does not pay or is delinquent in payment, the patient is responsible for the entire account. Account balances can be paid by cash, check or Visa/MasterCard. Top How much does insurance cover? Insurance companies normally cover 50% - 80% of restorative (fillings, crowns, bridges) and 90% - 100% of preventative (cleanings, exams, x-rays). Coverage varies with each insurance policy. For treatments considered extensive, a pre-treatment 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. Top 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 doctors 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. Top Please do not hesitate to ask questions regarding our office policies. The policies were designed to clarify confusing aspects of dental treatment and to provide explanations for common dental matters. We encourage questions and would like our patients to be educated on his/her dental health. Top |