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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 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. 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?
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. As
an additional option, we also provide third party financing through
CareCredit for some treatment plans
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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. 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 $3.00 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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