We work with most insurance companies and are happy to electronically file dental claims as a courtesy to our patients.
We do not accept secondary insurance as a form of payment due to the numerous limitations placed on the individual policies. However, we will gladly assist you by generating the claim forms for you to submit to your insurance.
By law your insurance company is required to pay each claim within 30 days of receipt. We file all insurance claims electronically so your insurance company will receive each claim within days of the treatment. Any unpaid claims over 30 days become your financial responsibility.
Dental Insurance Considerations
- No Insurance Pays 100% Of All Procedures: Dental insurance is meant to be an aid in receiving care. Many people believe that their insurance pays 90-100% of all dental fees. In reality, most plans only pay between 50-80% of the average total fee. Some insurance plans pay more and some pay less. Your amount of coverage is based on your employer’s choice of an employee insurance plan and the contract made between your employer and insurance provider.
- Benefits Are Not Determined By Our Office: You may have noticed that sometimes your dental insurer reimburses you or your dentist at a lower rate than the actual dentist’s fees. 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 is gives the impression that any fee greater than the amount paid by the insurance company is unreasonable or well above what other dentists in the area charge for a particular service. This is very misleading and is not accurate. UCRs are arbitrarily set by the insurance companies to guarantee a 20-30% profit. Unfortunately, insurance companies imply that your dentist is “overcharging” rather than saying that they are “underpaying” or that their benefits are low.
- Deductibles & Co-Payments: When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $150. Assuming that the insurance company allows $150 as its usual and customary fee, we can figure out what benefits will be paid. First, the deductible paid by you, on average is $50, is subtracted leaving $100. The plan then pays 80% for this procedure. The insurance company will then pay 80% of the $100, or $80. Out of the $150 fee they will pay an estimated $80 leaving a remaining portion of $70 to be paid by the patient. Of course if the UCR is less than $150 or your plan pays only 50% then the insurance benefits will also be significantly less.
- If You Have An Insurance Company That Directly Reimburses You Instead Of The Dentist: The total amount due for services rendered are due at time of checkout
- Please Keep Us Informed Of Any Insurance Changes Such As: policy name, insurance company, address, or change of employment