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Financial Information
In an effort to help our patients receive the care they need in a timely affordable fashion we have the following options to assist you:
- Receive a 5% discount for payments by cash or check (over $1000)
- We accept Visa, MasterCard and Discover
- Care Credit financing offering 6-12 months no interest or 24-60 months @14.9%interest
- In-house financing options include 3 months divided payments pre-authorized debit/credit card.
We accept most dental insurances. We submit insurance documents and wait for payment and ask for your estimated out of pocket expenses to be paid using financial arrangements 1, 2, 3 or 4. Should insurance not pay the expected benefit for any reason, the balance is required to be paid by the patient.
Let us help you understand your insurance
Understanding your dental benefit is not easy. There are as many different plans as there are contracts. Your employer has selected your plan and is ultimately responsible for how your contract is designed. Remember, whether your plan covers a major portion of your dental bill, or only a small amount, dental benefits are good for patients because they help pay for needed treatment.
It is important to know that each contract will specify what types of procedures are considered for benefits, Even if a procedure is medically and dentally necessary, it may be excluded from your contract. This does not mean that you do not need the procedure. It simply means that your plan will not consider the procedure for payment. For example, cosmetic procedures and implants are often excluded from a dental plan.
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Why doesn't my insurance cover all the costs for my care?
Dental insurance isn't really insurance (a payment to cover the cost of a loss) at all. It is actually a money benefit typically provided by an employer to help their employees pay for routine dental treatment. The employer usually buys a plan based on the amount of the benefits and how much the premium costs per month. Most benefit plans are only designed to cover a portion of the total cost.
But my plan says that my exams and certain other procedures are covered 100%
That 100% is usually what the insurance carrier allows as payment toward the procedure not what your dentist or any other dentist in your area may actually charge. For example say your dentist charges $75 for an examination (not counting x-rays). Your carrier may allow $60 as the 100% payment for that exam leaving $15 for you to pay.
How does my insurance carrier come up with its allowed payments?
Many carriers refer to their allowed payments as UCR which stands for usual, customary and reasonable. However, usual, customary and reasonable does not really mean exactly what it seems to mean. UCR is actually a listing of payments of all covered procedures negotiated by your employer and the insurance company.
This listing is related to the cost of the premiums and where you are located in your city and state. Your employer has likely selected an allowed payment or UCR payment that corresponds to the premium cost they desire. UCR payments could be more accurately called negotiated payments.
Since the payments are negotiated, does this mean that there is always a balance left for me to pay?
Typically there is always a portion that is not covered by your benefit plan.
If I always have a balance to pay, what good is my insurance?
Even a benefits plan that does not cover a large portion of the cost of needed dentistry pays something. Any amount covered reduces what you have to pay out of pocket... it helps!
Why is there an annual maximum on my benefits?
Maximums limit what a carrier has to cover each year. Amazingly, despite the fact that costs have steadily increased, annual maximum levels for dental care have not changed since the 1960's.
Why do some benefit plans require me to select a dentist from a list?
Usually the dentists on the list have agreed to a contract with the benefit plan. These contracts have restrictions and requirements. If you choose a dentist on the list you typically will pay less toward your dental care than if you choose a dentist not on the list.
Why doesn't my dentist participate in my dental benefits network plan?
Some plans require that the network dentists observe restrictions to treatment. Many dentists are not comfortable with this. We believe that the patient and the dentist should be the ones to decide together on the treatment needed, not the insurance companies.
What should I do if my insurance doesn't pay for treatments?
Because your insurance coverage is between you and your employer, and the insurance carrier, your dentist does not have the power to make your plan pay. If your insurance doesn't pay your are responsible for the total cost of treatment. Sometimes a plan may pay if patients send in claims for themselves. The Employee Benefits Coordinator at your place of business also may be able to help.
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