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