We understand that working with insurance companies can be difficult, time consuming and confusing. We will help give you guidance when dealing with your insurance company. Each company pays an insurance premium for specific coverage that fits the company’s budget. Therefore, each plan can be slightly different in its covered services. It is most beneficial when the patient is an active participant in understanding their insurance benefits.
Due to the nature of insurance, as providers, we have limited access to your policy and benefits. We encourage the insured to know and understand the policy’s coverage and exclusions. You can access your insurance information through your Human Resource Department or through your dental insurance company web site.
Our treatment recommendations are not dictated by insurance coverage; however, when presented with choices, we will help guide you and help you understand how best to utilize your benefits.
As a courtesy to you, we will electronically file your dental claim to your insurance company on your behalf. In order to do this, we will need the following information:
- The name of your employer
- The name of the insurance company along with the address where we need to send dental claims
- The dental insurance member ID number and/or group number
- Your social security number
Medical vs. Dental Insurance
Medical health insurance and dental insurance are different in that the more medical need you have, the more coverage you get. However, dental coverage actually limits how much treatment it will pay each year regardless of your need. Insurance companies are not concerned with what is required to preserve your teeth but rather with their own guidelines. It is our job, in fact our professional duty, to tell you what you need and what treatment would help you to stay your healthiest. Your dental insurance does not know what is best for your teeth.
A pre-estimate is the treatment necessary along with the fees we charge sent to your insurance company to determine what the insurance will cover along with the patient co-pay (your out-of-pocket expense). Without a pre-estimate, we can only estimate what we think they might cover. We can electronically file a pre-estimate for you.
As the insured and/or owner of the policy, please understand that:
Payment for services is due at the time services are rendered. If you have dental insurance, an estimated co-pay will be collected. Alternative payment arrangements MUST be made PRIOR to receiving treatment.
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 limited leverage to obtain information or payment from your insurance carrier.
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.
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.
Insurance is considered a method of reimbursing the patient for fees paid to the doctor and is not a substitute for payment.
To help us better serve you, please keep us informed of any changes in your insurance coverage or employment.
Click below to view our financial policy.