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

How are
Appointments Scheduled?
The office attempts to schedule appointments at your
convenience and when time is available. Preschool children should be seen in
the morning because they are fresher and we can work more slowly with them for their comfort. School children with a lot of work to be done
should be seen in the morning for the same reason. Dental appointments are
an excused absence. Missing school can be kept to a minimum when regular
dental care is continued.
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.
What about Finances?
Payment for professional services is due at the time dental treatment
is provided. We accept cash, checks, money orders and Visa or
MasterCard.
Our Office Procedures 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 are
responsible for knowing the terms of your plan, as we will collect the
estimated portion due at the time services are rendered. Your
responsibilities may include deductibles, rejected charges and
additional co-payments. By law, your insurance carrier is required to
pay each claim within 30 days of receipt. We file a majority of claims
electronically, so your insurance company will receive each claim within
days of the treatment. Although we will do everything possible to see
that you receive your maximum benefit, please be aware that we will
expect payment in full from you if we have not received insurance
payment within 45 days of treatment.
We are in-network providers with United Concordia and Delta Dental
Premier, but will file all of your claims regardless of your insurance
plan. We are not responsible for how your insurance company handles its
claims or for what benefits they pay on a claim. We are happy to assist
you in estimating your portion of the cost of treatment. We cannot
guarantee any estimate of benefits provided to you from our office.
Payment is determined by your insurance company upon receipt of a claim.
We are often asked the following:
Does insurance pay 100% of all procedures?
Insurance companies often lead patients to think that their coverage
pays 90% - 100% of all dental fees. However, most plans only pay between
50% - 80% of the average total fee. Some pay more, some pay less. The
percentage 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.
Does your office determine my benefits?
Our office does not determine your dental benefits. 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.
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