Please be aware that we file dental insurance as a courtesy to you. We cannot be held responsible for how your insurance company handles claims or for what benefits they pay on a claim or rule not to cover. We will always work hard to assist you in estimating your portion of the cost of treatment, but are unable to guarantee what your insurance will or will not do with each claim.
Benefits are not determined by our office. Dental insurance is meant to be an aid in receiving dental care. Many patients think dental insurance pays 90% - 100% of all dental fees. This is incorrect. Most plans only pay between 50% - 80% of the average total fee. The percentage is usually determined by what plan your employer has negotiated with your insurance carrier.
You may have noticed that often your dental insurer reimburses 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 of this nature gives the impression that any fee greater than the amount paid by the insurance company is unreasonable, or well above what dentists in the area charge for a certain service. This is not accurate and can be very misleading.
Insurance companies set their own fee schedules and each carrier uses a different set of fees they consider allowable. These fees vary greatly. These allowable UCR fees are often outdated and do not reflect the current UCR fee. As a result, insurance companies can make an additional 20% - 30% profit. Unfortunately, insurance companies imply your dentist is "over-charging" rather than saying they are "underpaying" or that their benefit coverage is minimal.
We are an In-Network Provider with most PPO Insurances.
We will be happy to file your claim. It will help if we receive your insurance information prior to your child’s appointment. Furthermore, it will help if you are familiar with your insurance benefits, as we will collect the estimated amount insurance is not expected to pay (co-pay and/or deductible). We accept cash, personal checks debit cards, Visa, Mastercard and Discover. For your convenience, we also provide third party financing through CareCredit.
We prefer the appointment day to be reserved for clinical matters. By law any procedures not covered by your dental insurance can be collected at the dentist's usual and customary fee instead of the insurance's contracted amount.
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