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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.
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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 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.
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