The Role of Insurance

Understanding your insurance coverage can be quite challenging.  Our goal is to assist you in maximizing your benefits.  We care for patients who have insurance coverage from many different companies.  Each company pays an insurance premium for specific coverage that fits the company's budget.  Each plan can be slightly different in its covered services.  We encourage you, the insured, to become familiar with your policy's coverage (and exclusions).

 

As a courtesy to you, our office will:

  1. File your insurance claim within 24 hours of your visit and request payment of your benefit to you after payment is received.
  2. Electronically file your insurance claim for a short turnaround, when available.
  3. Research your claim one time within 60 days.
  4. Re-file your claim a second time within 60 days, if necessary.
  5. Follow the American Dental Association's guidelines for coding procedures and filing insurance.

As the insured and/or owner of the policy, please understand that:

  1. Payment for services is due at the time services are rendered.  (Alternative payment arrangements MUST be made PRIOR to receiving treatment.)
  2. Your insurance is a contract between you, your employer, and the insurance carrier.  We are not a party to that contract.  Because the insurance policy belongs to you, we have no leverage to obtain information or payment from your insurance carrier.
  3. Insurance policies restrict payment for some services, use restricted fee schedules and exclude some procedures based on various criteria.  Restrictions are a result of the premium paid.
  4. Our treatment recommendations are believed to be the best care in the given circumstances.  As health care providers, our relationship is with you, not your insurance company.  Insurance coverage does not influence our recommendations.
  5. Insurance is considered a method of reimbursing the patient for fees paid to the doctor and is not a substitute for payment.
  6. You must keep us informed of any changes in your insurance coverage or employment.

If questions arise concerning this information, please let us know.

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