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 portion, which is due at each visit.
WHAT METHODS OF PAYMENT DO YOU ACCEPT?
We accept personal checks, debit cards, and most major credit cards. Additionally we accept Care Credit, which is a deferred interest payment plan. For further questions please ask one of our team members for an application.
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 your estimated portion 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.
YOU MUST BE FAMILIAR with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay. You should be aware that your insurance company does not guarantee payment over the telephone. We will not know the exact amount they pay until they respond to the claim that we file. Regardless of what your insurance company decides to pay, you remain responsible for payment of your bill in full. By law your insurance company is required to pay or deny each claim within 90 days of receipt. We file all insurance electronically, so your insurance company will receive each claim within days of the treatment. Once we receive payment on your claim, we will send you a bill for any balance remaining on your account. . Any balances unpaid after 30 days will result in a finance charge of 1.8% per month. If collection and or legal services are required to obtain payment, all legal fees and costs incurred will be your responsibility. We will be glad to send a refund to you if your insurance ultimately pays us.
PLEASE UNDERSTAND that we file dental insurance as a courtesy to our patients. We do not have a contract with your insurance company, only you do. 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 at no time guarantee what your insurance will or will not do with each claim. We also cannot be responsible for any errors in filing your insurance. Once again, we file claims as a courtesy to you.
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 simply 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.
FACT 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. Insurance companies set their own schedules, and each company uses a different set of fees they consider allowable. These allowable fees may vary widely, because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a level they call the “allowable” UCR Fee. Frequently, this data can be three to five years old and these “allowable” fees are set by the insurance company so they can make a net 20%-30% profit.
FACT 3 DEDUCTIBLES AND YOUR ESTIMATED PORTION MUST BE CONSIDERED
When estimating dental benefits, deductibles, percentages of coverage and co-payments must be considered.
For instance, 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.