Although we do not accept insurance as full payment, we will do all we can to help patients derive maximum benefits from their insurance coverage.
We provide an “attending doctors” statement for each treatment visit. This can be attached to your claim form, and is accepted by your insurance company. When requested, we will provide a “pre-treatment estimate” of anticipated expenses to be submitted to your insurance carrier for a “Pre-determination of Benefits.”. This lets you know how much the insurance carrier will reimburse for services performed here. Please understand that every insurance policy is different, and we have no way of knowing the exact amount a particular policy will pay.
Our insurance coordinators deal with many different insurance companies. Some companies offer many different dental and medical plans. These companies often change benefits, co-pays, and deductibles. We do our best to provide you with accurate coverage estimates based on information available to us. At times, it is almost impossible to accurately estimate a patient’s insurance co-payment. Many insurance companies will not give out reimbursement amounts until after the treatment is completed. Dealing with these companies can be difficult and time consuming. As a courtesy, we ask that you keep us informed of any change to your insurance. It is important that all information about you and your insurance is current.
Although we will gladly file a claim on your behalf, you may wish to submit the claim yourself. In general, insurers process claims filed directly by patients faster than those filed by the service providers (dental offices). Just be certain to ascertain exactly what information your carrier requires.
Further, most dental insurance policies are limited and usually only pay for a portion of the procedure(s) that may need to be performed. The majority of dental plans reimburse approximately 30-80 percent of treatment costs, depending on procedures performed and your company’s plan. Upon receipt of an insurance payment, any over-payment will be refunded to you.
If a patient comes to us with a problem that they expect to be covered by medical insurance (biopsies, tumors, TMJ, infections), they must have a referral from their primary care physician, if required by their plan. A referral from a dentist is not adequate for medical insurance coverage. Obtaining a medical referral is the patient’s responsibility. We cannot obtain the referral for you and the referral cannot be obtained retroactively. If you do not have a referral, we will be happy to see you, but your medical insurance company may not pay for your treatment.
Dental procedures (including root planing, gum surgery, tooth extraction and implants) are not covered by Medicare.