How are Appointments Scheduled?
Do I Stay
with My Child During the Visit?
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.
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Do I Stay with My Child During the Visit?
We ask that you allow your child to accompany our
staff through the dental experience. We are all highly experienced in
helping children overcome anxiety. Separation anxiety is not uncommon in
children, so please try not to be concerned if your child exhibits some
negative behavior. This is normal and will soon diminish. Studies and
experience have shown that most children over the age of 3 react more
positively when permitted to experience the dental visit on their own and in
an environment designed for children.
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What About Finances?
Upon
completion of the examination, a recommended treatment plan and an itemized
outline of costs will be presented to you prior to beginning any treatment.
If you have dental insurance we will provide an estimate of your insurance
benefits. Every effort will be made to be as accurate as possible, however,
these are estimates and your exact benefits are determined by each
individual insurance policy benefit package.
We
will assist in filing your insurance claims within 24 hours of providing
services. If assignments of benefits are assigned to you and not our
office, payment for all service provided are payable at the time of the
appointment. In this case your insurance company will reimburse directly
to you for your benefits due. Your insurance benefits are a contract
between you and your employer. The amount you will receive will depend
on the quality of the plan purchased by your employer.
Payment is due at the time services are provided. unless
other financial arrangements are made prior to beginning treatment. We
accept cash, check, Visa, MasterCard or Discover Card.
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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. Payment from the
responsible party for services not covered by insurance is due at the time
of treatment. By law your insurance company is required to pay each claim
within 30 days of receipt. 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 re-billing fee of 1.5% will be
added to your account each month until paid. We will be glad to send a
refund to you if your insurance pays 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.
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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