Insurance and Payment
We are honored that you have chosen our practice as your venue to receive quality dentistry. Whether you have insurance or not, we are committed to the delivery of high-quality dental care. We accept all PPO insurance and will be happy to file your claim as a courtesy to you. You should be familiar with your insurance. Our staff will be happy to assist you in understanding your benefits.
Dental insurance is a contract between you (the insured), the insurance company (the insurer), and perhaps your employer. We are not a party to the contract. Insurance companies have told us it is not their job to do what is best for patients. The insurance company's duty is to manage money as the policy is written. In some cases, the insurance policy will not pay anything towards certain procedures, regardless of whether it is necessary or in the patient's best interest. For this reason, we decided we can best serve our patients if we are not in contract with a party whos primary interest is to manage money. However, we will work with you and your dental insurance company to maximize your benefit.
Extensive research has shown that our fees are within a median range and very competitive for the region. The vast majority of our patients have insurance that considers our fees to be usual and customary. On rare occasion, dental insurance companies state that the reimbursement was reduced because a dentist’s fee has exceeded the allowable amount used by the company. This can be misleading because it implies that a dentist has overcharged, while our data would actually argue that the insurance company has underpaid. Insurance companies collect fee data and may apply an arbitrary factor to dictate their allowable fee. Sometimes their fee data is several years old and not representative of the current usual, customary, and reasonable fee. Some insurance companies pay a lower allowable fee in order to maintain a profit.
As health care providers, our commitment is to deliver quality care. We will recommend what is in your best interest and seek your guidance in the event that your insurance provider does not allow a benefit for the recommended treatment. We will do our best to determine an accurate estimate of benefits before your appointment. If your treatment is of urgent nature, we may not have the 3-6 weeks most insurance companies require for a pre-treatment estimate.
Copayments and deductibles must be considered. For illustration purposes, let us assume you have a $50 deductible, insurance covers 80% of a procedure, and our fee of $150 is within your insurance company’s allowable range. First, the deductible ($50) is paid by you. This leaves $100 for your insurance company to pay 80% of, or $80. Your remaining portion is $20. For this $150 procedure, your out-of-pocket amount is $70 and your insurance will pay $80.
Your portion of payment is due at the time the service is rendered. A few dental insurance companies will reimburse you for the service rather than sending payment to our office. In this circumstance, we will advise you of the arrangement and payment for the entire amount will be due at the time of service.
In the event that you cancel your appointment with less than 2 days of notice, do not arrive for your scheduled appointment, or reschedule your appointment twice, we reserve the right to request a deposit before scheduling your next appointment.
As a service to you, we facilitate financing through CareCredit. You may apply for financing at CareCredit.com. We also have a number of patients who acquire very good financing arrangements through their bank or financial institution.