What about Finances?

We are participating providers of Delta Dental, MetLife, AETNA, Guardian, and Cigna Insurances.

If you have Blue Shield or United Concordia dental insurance, payment is due at the time of service. These insurance companies do not send payment to a dentist who does not participate with them. These insurance companies will issue you a check based on their payment schedules.

Our staff will be glad to assist in the preparation of insurance documents so that you get the maximum allowable reimbursement from your insurance provider.

We do not participate with any HMO or DMO plans. For patients without dental insurance, payment for dental services is due at the time that treatment is provided. Every effort will be made to provide a treatment plan that gives your child the best possible care, and fits into your timetable and budget. For payments, we gladly accept Visa, Mastercard, Discover, and American Express, along with cash and personal checks.

Our Office Policy Regarding Dental Insurance

If we have received all of your insurance information on the day of the appointment, we will be happy to file your claim for you. We file all insurance electronically, so your insurance company will receive each claim within days of the treatment.

For patients with insurances that we do not participate with, PLEASE UNDERSTAND that we file dental insurance as a courtesy. We are not responsible for how your insurance company handles its claims, or for what benefits they pay on a claim. We can only assist you in estimating your portion of the cost of treatment. We do not guarantee what your insurance will or will not do with each claim. We are not responsible for any errors in filing your insurance. Once again, we file claims as a courtesy to you.

Fact 1 - NO INSURANCE PAYS 100% OF ALL PROCEDURES
Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 90-100% of all dental fees - this is not true. Most plans only pay between 50-80% of the average total fee. Some pay more, some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage, or the type of contract your employer has set up with your insurance company.

Fact 2 - BENEFITS ARE NOT DETERMINED BY OUR OFFICE
Sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist's actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist's fee has exceeded the usual, customary, or reasonable fee ("UCR") used by the company.

A statement such as 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 is not accurate.

Insurance companies set their own schedules, and each company uses a different set of fees they consider reasonable. These reasonable fees may vary.

Unfortunately, insurance companies imply that your dentist is overcharging, rather than say that they are underpaying, or that their benefits are low. In general, the less expensive insurance policy will use a lower reasonable (UCR) figure.

Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED
When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume a service fee 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 averages $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 at 50%, then the insurance benefits will also be significantly less.

MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.