How will I know what to pay at each visit?
Payment is due the day services are rendered. We will review with you the treatment planned and the costs prior to any treatment. If you have no insurance, payment in full is expected at each visit. If you have insurance, we will check your benefits and inform you of your estimated co-payment, which is due at each visit.
What methods of payment do you accept?
We accept checks, cash, MasterCard, Visa, and Discover.
How does dental insurance work?
We are insurance friendly and will gladly assist you in understanding and maximizing your benefits. We ask that you keep us informed of any updated insurance changes before each visit, such as policy name, insurance company address, or a change of employment. As a courtesy, we are happy to file and track claims electronically for you.
We will make every effort to accurately estimate your co-payment based on the information given to us from your insurance company representative. We will review your child’s treatment plan, benefits and estimated co-payments with you prior to any treatment. Keep in mind, the coverage quotes we receive from the insurance company are estimates only and not a guarantee of payment.
On the day services are rendered, you will be asked to pay the portion estimated that the insurance will not cover. If the insurance company does not allow assigning of benefits, which means they will only send the remaining payment to you rather than our office, then you will be asked for payment in full on the day of services.
We know insurance can be confusing, if you should have any questions regarding insurance, please ask us. We are happy to help!
Helpful Facts for Understanding Insurance
Fact 1 – No insurance pays 100% of all procedures.
Dental insurance is only meant to be an aid in receiving dental care. Many patients think that their insurance pays 100% of all dental fees. This is not true. Most plans only pay between 50%-80% of the average total fee.
Your employer has determined the amount of coverage according to the contract set up with the insurance company. The less paid for the insurance by your employer, the less coverage you will receive.
Facts 2 – Benefits are not determined by our office.
Insurance companies often state that the dentist’s fee has exceeded the usual, customary, or reasonable fee (UCR). This gives the impression that any fee greater than the amount paid by the insurance company is unreasonable, or well above what most dentists in the area charge for a certain service. This can be very misleading and simply is not accurate.
The insurance company arbitrarily chooses a level that they call “allowable” UCR fee. The “allowable” fees are set up by the insurance company so they can make a net profit. Our fees are within the range of other pediatric dental offices in the area.
Fact 3 – Deductibles and Co-Payments must be considered
When estimating dental benefits, deductibles, percentages of coverage and co-payments must be considered.
For example, let’s 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, 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 50%, then the insurance benefits will also be significantly less.
Please keep in mind that you are ultimately responsible for payment on your account. If your insurance does not pay the claim, you are responsible for the outstanding balance. Insurance is a contract between you and the insurance company, not our office.