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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.
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.
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.
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 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.off
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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