We are pleased that you have dental insurance!
Your dental benefit program will assist you in obtaining and maintaining a superlative level of oral health. Our office understands Dental Insurance, and we will be glad to assist you in obtaining the maximum benefits specified in your contract.
You can understand, however, that…
- Your dental benefit program is a contract between you, your employer and the insurance company. We are not a party to that contract.
- There are over 400 companies offering dental insurance with thousands of individual/group plans available in the USA. While we are pleased to file insurance claims for you, it is extremely difficult for us to keep track of all the individual requirements of the plans. Each one has different stipulations regarding how often services may be rendered, and even more importantly, where those services may be performed. Even with the same insurance company, the plans differ depending upon what type of contract you or your employer has negotiated.
- Providing quality dental care to our patients is our primary concern, but not all dental services are a covered benefit in all contracts. We are more than willing to provide that care within your insurance contract guidelines if you let us know at EACH time of service exactly what those guidelines are. Unfortunately, if you do not inform us of any requirements in your contract, and we subsequently perform services that are not covered, we will have no choice but to bill you directly for those charges. Payment for those charges is then your responsibility.
- We’ve found that most plans cover about 35% to 65% of major services based on the plan’s pre-established maximum fee allowance which varies from carrier to carrier.
- The amount your plan pays is determined by how much your employer paid for the plan minus insurer administrative costs and profits which can vary between 6-50%.
- Payment for any service rendered to you, of course, ultimately remains your responsibility.
Any of us will gladly discuss your proposed dental treatment and answer any questions you might have as to the involvement of your dental benefit program in receiving this care.