Financial/Insurance

Payments

Payments are due at the time of service. We offer a 5% courtesy discount for full payment at the beginning of services rendered. Payment plans are also available extended up to 3-6 month interest free. There is a 1% interest charge on any balance remaining after 90 days. For you convenience we accept most major credit cards and participate with CareCredit and other alternative options for payment arrangements.

Insurance

We take care of our patients based on their treatment needs and not based on the limitations of their dental insurance. There is a great deal of confusion about dental insurance. We do not work for any insurance company or for any PPO or HMO. We work for you. Our treatment recommendations are based solely on what we feel will give you the best outcome. Insurance companies’ treatment recommendations are based solely on what is best for their profit margins.

With this in mind, we are a fee for service office. This means that we do not let an insurance company dictate when, where, or how to treat patients. Fees for our services are the responsibility of the patient. We do everything possible to maximize insurance benefits including filing to your dental and medical insurance carriers. Their reimbursement to you is based on your plan that we negotiated between your employer and the insurance company.

There are two methods commonly used by dental insurance companies to limit your reimbursement. The first is the payment schedule, which limits the amount covered for any particular procedure. Most of these benefit tables are based on faulty and outdated information and cannot be justified. An insurance company may also limit payment because they claim the fee was greater than the “usual and customary”. Again, it is impossible to ascertain how the insurance company arrived at their “usual and customary” figures, which can be less than half of those found in nationally published data. Moreover, we are not satisfied with “usual” or “customary” and you can expect unusual and extraordinary care at our office.

The second – and most restricting – limitation to benefits is the yearly maximum payment the dental insurance company will reimburse. Regardless of the procedure coverage, most dental insurance companies will cap payment between $1000 and $2000 a year. Thus, if the insurance company’s scheduled re-imbursement for a $3000 procedure were $2400, they would still only pay up to their yearly maximum of, say, $1500.

While we are not directly involved with any insurance company, we will do all we can to help you derive maximum benefits from your insurance plan. For new patient consultations and dental cleanings, we provide “attending doctor” statements for you to attach to your insurance claim form. For more extensive treatment we will submit a pre-treatment estimate to your insurance company, when requested, to determine what reimbursement is available for anticipated services. After that treatment is completed, our office will then send in a final insurance claim for you.

We have a staff member whose sole job is to help patients receive as much as possible from their insurance company, but remember this is done as a courtesy to our patients. Each patient is entirely responsible for his or her bill.