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How are Appointments Scheduled?
What About Finances?
Our Office
Policy Regarding Dental Insurance

How are
Appointments Scheduled?
Our
office makes every effort to schedule appointments at your convenience and
when time is available. Preschool children should be seen in the
morning because they are fresher, more attentive, and usually accept
treatment more readily. School children with a lot of work to be done
should be seen in the morning for the same reasons. Although dental
appointments are an excused absence, we will make every attempt to keep
absences to a minimum. Regular dental care is one way to ensure this.
Since appointed times are reserved exclusively for
each patient we ask that you please notify our office 24 hours in advance of
your scheduled appointment time if you are unable to keep your appointment.
Another patient who needs our care could be scheduled if we have sufficient
time to notify them. We realize that unexpected things can happen, but we
ask for your assistance in this regard.
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What About Finances?
Payment for professional services is due at the time
dental treatment is provided. Every effort will be made to provide a
treatment plan which fits your timetable and budget, and gives your child
the best possible care. We accept cash, personal checks, debit cards and
most major credit cards.
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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. You must be
familiar with your insurance benefits, as we will collect from you the
estimated amount insurance is not expected to pay. By law your insurance
company is required to pay each claim within 30 days of receipt. We file all
insurance electronically so your insurance company will receive each claim
within days of the treatment. You are responsible for any balance on your
account after 30 days, whether insurance has paid or not. If you have not
paid your balance within 60 days a finance charge of 1.5% will be added to
your account each month until paid. Once your insurance company has paid us,
if a credit balance exists, we will be glad to send you a refund for the
overpaid amount.
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 can not be
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 the insurance company.
Fact 2 - BENEFITS ARE NOT DETERMINED BY OUR OFFICE
You may have noticed that 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 simply is not accurate.
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.
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 usual,
customary, or reasonable (UCR) figure.
Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED
When estimating dental benefits, deductibles and percentages must be
considered. To illustrate, 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 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.
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