How are appointments
scheduled? |
Do I stay with my child during the
visit?
What about finances?
| Our Office Policy Regarding
Dental Insurance |
Office Tour
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.
Do I stay with my child
during the visit?
We invite you to stay with your child during the
initial examination. 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 are more than welcome to accompany
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.
What about finances?
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.
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 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.
Photos to be applied soon.
Please visit again!
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