Dental Insurance
For your convenience, we do accept assignment for and file for many dental
insurances. We charge you an estimated out of pocket. This
estimated amount cannot be considered
as a definite amount due until your insurance carrier actually pays the
insurance claims. We must stress that this is a courtesy and that the
relationship of insurance is between you and your insurance carrier and we are
merely attempting to assist our patients with the cost of their dental
treatment. If the dental insurance company does not pay all of the estimated
portion within 60 days, the remaining balance becomes due
and payable by you, the patient.
Please keep in mind that the information we keep on file for you is only the
very basic information. It is not
intended to be an exact determination of benefits provided.
Every year your dental policy may change. You may receive notices of changes in
your dental policy by mail. Please familiarize yourself with your dental policy
and with any changes your insurance company brings to your attention.
If you have any questions, the human resources department at the employer your
insurance is through should be able to help you or feel free to ask us and we
will do our best to assist you!
FAQs about your Dental Insurance
Q. How do I know if you take my insurance? Will you file my dental
insurance for me?
A. We accept assignment for most dental insurance companies as long
as we’re not required to be a part of a network. We are not members of any PPO
networks. As a service and a courtesy to all of our patients, we do file your
dental insurance for you and accept assignment* of benefits. This does not mean
that we adjust off a balance that the insurance does not pay. You are
responsible for any balance that your insurance doesn’t cover. *accept
assignment means we will accept what the insurance pays and have you pay only
your out of pocket.
Q. How do I find out what my insurance covers?
A. Once you
come in and the Doctor does an exam, we will give you an estimate of how much
your treatment will cost and how much your insurance should pay and what you
should owe.
Q. I have dental insurance, what do I have to pay?
A. Once we determine your insurance benefits, by calling your
carrier, we will give you a treatment proposal stating what treatment the doctor
feels is in your best interest. That treatment proposal will have our fee for
that service and an estimate of what your insurance should pay and what you
should owe. We emphasize that this is an estimate, because we don’t know all the
details of your policy and many times the person we speak to on the phone could
give us incorrect information. (on their recording it states that the
information they give us is not a guarantee of payment) Therefore, we remind you
that you are ultimately responsible for any amount of that estimate should your
insurance company not pay.
Q. I have dental insurance, so why do I have to pay and my insurance
reimburse me?
A. Some insurance companies require that you see a dentist who is a
part of a preferred provider network (PPO). Our office does not participate in
any network programs because these insurance companies dictate to the doctor
what services and fees he is allowed to perform. We do not believe the insurance
company belongs anywhere in your diagnosis. Wherever insurance companies are
allowed to have the final say in your health care, it is you, the patient who
will suffer. In this case, if you are a member of a PPO, if we can file for you,
we will. We will do everything we can to assist you. In some cases, even though
we are not on their network they will still allow you to see us and assign a
lower benefit. It just depends on your policy. We will gladly call & help you to
find out what type of policy you have.
Q. My insurance covers 2 free cleanings a year. Why do I still have to
pay?
A. This is a very common question from our periodontal patients. The
problem with this, begins with how it was stated. If you check in your policy,
your insurance policy states that they cover 100% of usual and customary fees
for preventive services. However, they do not consider all cleanings to be
preventive. Cleanings for people who have any stage of gum disease usually fall
under the Basic Services of your Dental Benefits. There is nothing we can do
about this. That has to do with how your policy is written.