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
treatment
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 48 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 invite you to stay with your child during the
initial examination if your child is in pre-school or younger. During future appointments, we suggest you allow your
child to accompany our staff through the dental experience. We can usually
establish a closer rapport with your child when you are not present. Our
purpose is to gain your child's confidence and overcome apprehension.
However, if you choose, you may come with your child to the treatment room.
For the safety and privacy of all patients, other children who are not being
treated should remain in the reception room with a supervising adult.
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What About Finances?
For patients not
covered by insurance, full payment must be made at time of treatment. We
accept cash, personal checks, debit cards and most major credit cards.
Payment plans can be arranged for extensive orthodontic services.
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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. 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.
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. We are happy to
file your claim. We collect 30% of estimated treatment plans
at time of treatment (unless we hear from your insurance before).
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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