Financial and Insurance Guidelines

We welcome your child and family into our practice.  We are committed to providing your child/children with the best possible care and positive experience, while trying to control our fees and your cost.  In order to achieve these goals and focus on caring for your child, we need your assistance and understanding of our payment guidelines.

 

What insurance do we participate with (In-Network)?

 

United Health Care
Health Partners (open access, extended network or our office is specified on the card)
Delta Dental Premier
Delta Dental PPO
 

What if your child needs treatment? 


A treatment plan will be done for each child that needs additional dental attention. This is an outline which lists the recommended treatment and cost. We require that a partial deposit of the total cost of treatment be paid at the appointment time, even if you have insurance.  A prior estimate of the treatment can be sent into your insurance company upon request from the parent.

Any account that is overpaid will receive a prompt refund.  Our office reserves the right to stop filing your insurance if at any time there is a problem with your account because of your carrier or an unwillingness to cooperate.  It is your responsibility to give accurate insurance information so that filing the claims can be done on a timely manner.

If at 60 days the insurance company has not paid, arrangements for your payment on the account must be made. You should contact your insurance company immediately regarding the non-payment of your claim. 

What if my child does not have dental insurance and needs treatment? 

A treatment plan will be done for each child that needs additional dental attention. We require that payment be made at the time of service. A 5% savings is offered when payment is made by cash, check, Visa, MasterCard and Discover. As a convenience to our patients, we also offer Citi and Care credit Health cards.

All Patient Accounts

A late charge of 1.5% per month billing cycle will be applied regardless of insurance involvement.

All balances are due at 90 days. If the account is not paid, the collection proceeding will begin. All charges incurred in the recovery of a delinquent account will be the patients responsibility. We regret when this action is necessary, but we feel our office makes significant efforts to help our patients provide payment. 

Facts You Should Know About Dental Insurance: 

In an effort to help you understand your insurance policy and maximize your insurance benefits, we would like to share some facts about dental insurance with you.

  • Fact #1 - Dental insurance is a contract between you, your employer, and the insurance company. We are not a party to that contract.

  • Fact #2 Dental insurance is NOT meant to cover all fees. It is meant to be an aid to your investment in your child's dental health care.  Many routine dental services are not covered by dental insurance.

  • Fact #3 - Many carriers claim that they reimburse the insured promptly "up to 80% or up to 100% of the total fees." In actuality, we have found that most plans cover about 40% - 50% of average fees. Some plans pay more and some less. The less paid for the insurance by your employer, the less coverage you will receive.

  • Fact #4 - Usual, Customary or Reasonable Fees, (UCR), a term used by your insurance carrier, is an arbitrary amount which the insurance company chooses to pay for each procedure.  It is not based on the average charge of practicing specialists in the area; it is merely the "allowable" amount they will reimburse so they can make a net 20% - 30% profit. Our fees are within range of other pediatric dental offices in the area.

  • Fact #5 - Insurance companies will not release the exact amount they will pay for a procedure until the treatment is completed and the claim is submitted.  They will only state the percentage of their fee schedule that they will cover.

We will file your insurance at no charge.  In order to provide this service, we will need your updated and accurate insurance information before each appointment.

Please do not hesitate to ask questions about our financial policy.  We want you to understand and be comfortable with our policies.  If you have any questions regarding your insurance, we ask that you contact your company regarding the specifics and details of your plan.