Insurance

Our Office Policy on Insurance

If we have received all of your insurance information 72 hours prior to 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% or $5, whichever is greater, 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.

MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.

Other Payment Options

  • Visa, Mastercard, Discover, American Express
  • 0% financing through Care Credit

More Insurance Information

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.

Benefits are not Determined by Our Office

An insurance company will use data from claims it processes to set a usual, customary, or reasonable fee (UCR) for dental services. These fees are set in such a way that the insurance company will make a net 20-30% profit. Unfortunately, this data can be 3-5 years old and vary widely across different companies. As a result, sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist’s actual fee. Insurance companies may say this is because the dentist’s fee exceeded the UCR. 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 UCR figure.

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.

Out-of-Network Insurance Plans are Accepted

Even if our office is out of network with your dental insurance plan, you can still use your insurance benefits with us. Our office will still accept and file your insurance claim as normal. You will be responsible for co-pays and deductibles due at the time of treatment. For many patients, choosing an out of network dentist makes a minimal difference in fees. However, some insurance plans might reduce plan benefits. Our office will help estimate fees, file and process your insurance claim, but it is ultimately your responsibility to understand covered benefits with an out of network dentist. Having a PPO insurance gives you choice and freedom to see any dentist that you want. It is most important that you chose a dentist you have trust in and feel comfortable seeing!

More Insurance Information

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.

Benefits are not Determined by Our Office

An insurance company will use data from claims it processes to set a usual, customary, or reasonable fee (UCR) for dental services. These fees are set in such a way that the insurance company will make a net 20-30% profit...
Unfortunately, this data can be 3-5 years old and vary widely across different companies. As a result, sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist’s actual fee. Insurance companies may say this is because the dentist’s fee exceeded the UCR. 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 UCR figure.

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.

Out-of-Network Insurance Plans are Accepted

Even if our office is out of network with your dental insurance plan, you can still use your insurance benefits with us. Our office will still accept and file your insurance claim as normal. You will be responsible for co-pays and deductibles due at the time of treatment. For many patients, choosing an out of network dentist makes a minimal difference in fees...
However, some insurance plans might reduce plan benefits. Our office will help estimate fees, file and process your insurance claim, but it is ultimately your responsibility to understand covered benefits with an out of network dentist. Having a PPO insurance gives you choice and freedom to see any dentist that you want. It is most important that you chose a dentist you have trust in and feel comfortable seeing!

Have any questions? Let us know!