We are dedicated to providing the best treatment for our patients regardless of fees or insurance coverages.
Please note the following:
We must emphasize that as health care providers, our relationship is with you, not your insurance company. Your insurance is a contract between you, your employer and the insurance company. We are not a party with that contract.
The amount not covered by your insurance is payable at the time of service, such as deductibles and co-payments. However, if we do not receive payment from the company within 40 days after the submission of the claim, you will be expected to pay for all dental services in full within 10 days of notification. In the event of duplicate payment, you will be reimbursed.
You are responsible for payment regardless of any insurance company's arbitrary determination of fees. Please be aware that some services provided may be non-covered services and not considered reasonable and necessary under your dental insurance.
We will do our best to maximize the insurance benefits that you are eligible to receive and we do appreciate your prompt settlement of any charges that may be incurred during treatment.
Your dental coverage is NOT determined by your childs dental needs, but by how much your employer contributes to the plan.
UCR (Usual, Customary and Reasonable) are the maximum amounts that will be covered by the Plan for eligible services. The plan pays an established percentage of the dentist's fee or pays the plan sponsor's "customary" or "reasonable" fee limit, whichever is less. Although these limits are called "customary," they may or may not reflect the fees that area dentists charge. Exceeding the plans customary fee, however, does not mean your dentist has overcharged for the procedure. THERE ARE NO REGULATIONS AS TO HOW INSURANCE COMPANIES DETERMINE REIMBURSEMENT LEVELS, RESULTING IN WIDE FLUCTUATION. In addition, insurance companies are not required to disclose how they determine "usual, customary and reasonable" charges.
Employers offer dental benefits to help employees pay for a portion of the cost of their dental care. Dental plans are designed to share in the cost of your dental care, not to completely pay for those costs. Almost all dental benefit plans are the result of a contract between the plan sponsor (usually an employer or a union) and the third-party payer (usually an insurance company). THE AMOUNT YOUR PLAN PAYS IS DETERMINED BY THE AGREEMENT NEGOTIATED BY YOUR EMPLOYER WITH THE INSURER.