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Appointments
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Policies / Insurance
Policies /
Office Tour
Appointments
The office
attempts to schedule appointments at your convenience and when time is
available. Our office makes every attempt to remain on schedule throughout
the day. We value your time and will do our best to keep you from having
to wait.
Preschool
children should be seen in the morning because they are fresher and we can
work more slowly with the child 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.
Payment
Policies
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.
Insurance
Policies
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% or $5,
whichever is greater, will be added to your account each month until paid.
We will be glad to send a refund to you once insurance has paid 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 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.
Insurance
companies will not release the exact amount they will pay for a procedure
until the treatment is completed and the claim is submitted. They will
only state the percentage of their fee schedule that they will cover.
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. Our fees are within range of other dental offices in the area.
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.
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