Pediatric Dentistry Insurance Details
We are currently participating providers with Delta Dental and Anthem and will file claims on your behalf to all other insurance companies as a courtesy.
You may find the points below helpful in understanding dental insurance:
Dental insurance is a contract between you, and/or your employer and your insurance company. We are not a party to that contract.
Our recommendations for treatment are based on what will be best for your child and not what your insurance may or may not pay. If you have any concerns about your coverage, please contact your employer or your insurance company.
Dental insurance typically does NOT cover all fees. Most plans routinely pay between 50-75% of the average total fee for a procedure. The percentage your plan pays is determined by how much you or your employer has chosen to pay for dental coverage.
Many insurance companies do not pay the difference between white fillings (composites) and silver fillings (amalgams). You are responsible for any difference in cost, since composites are more expensive to place.
Usual, Customary, or Reasonable Fees (UCR) is a term used by your insurance company. It is an arbitrary amount the insurance company is willing to pay for a procedure and is not based on the average fees charged by dental specialists in the area. There is great variation between insurance companies as to what they consider Usual, Customary, or Reasonable Fees. Our fees are based on the national fee schedule recommended by the American Academy of Pediatric Dentistry.
Though we are not obligated to do so, we will file your insurance claim as a courtesy to you. Any amount estimated not to be covered by your insurance company is payable at the time services are rendered. Please remember this is only an ESTIMATE and not a guarantee of what your insurance will pay. You may receive an additional bill or a refund check from us depending on what insurance actually pays on your claim.
We allow a maximum of 45 days for insurance reimbursement. After this period, any amount unpaid by your insurance company is due in full, by you, within 30 days. Because your dental insurance is a contract between, you, your employer and the insurance company, some carriers will only send reimbursement to you, not our office. It is your responsibility to notify us immediately if your insurance company has sent our payment to you.
We reserve the right to require payment in full on day of service if we find that the insurance company repeatedly sends our reimbursement to you. The insurance carriers are billed electronically after each visit, unless the company specifies paper statements. It is your responsibility to supply this office with necessary forms to complete the billing if needed.
We reserve the right to stop filing your insurance if at any time there is a problem with your account because of your insurance company, or your unwillingness to cooperate.
Orthodontic Insurance Details
We strive to provide you with affordable, high-quality treatment that fits your budget! We offer a variety of payment options to meet your needs. Our office accepts payments by cash, checks, and Visa, MasterCard and Discover credit cards. We offer no-interest financing options with auto-debit payments through our office, as well as the CareCredit system.
We also offer discounts for patients paying for their treatment in full up front, as well as multiple family members undergoing treatment at the same time.
If you have any questions about financing or payment, ask us! We will thoroughly explain your choices and work hard to accommodate your needs.
If your insurance covers orthodontic treatment, you will receive the benefit of reduced personal costs. Many insurance policies have a lifetime orthodontic benefit that is distinct from regular dental insurance. Insurance policies vary, so we will review your insurance to determine the appropriate course of action. Once treatment has started, we will file your claims. To help us with your insurance filing, please complete the insurance questions on our questionnaire. Please remember that orthodontic insurance is a benefit for you or your child. If, during the course of treatment, your benefits change, the financially responsible party is accountable for all charges.