How are Appointments
Scheduled |
Do I
Stay with My Child During the Visit |
What About Finances
Our Office Policy Regarding
Dental Insurance
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 the child 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.
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 may come
with your child to the treatment room during morning
appointments. 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.
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 finance charge of
1.5% will be added to your account each month until
paid. We will be glad to send a refund to you once
insurance has paid 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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