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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 the child 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.
Do I Stay with My Child During the Visit?
Parents are welcome to accompany their child through the
dental visit. If your child is over the age of 3, however, we recommend that
you allow them to accompany our staff through the dental experience. Studies
and experience have shown that most children over the age of 3 react more
positively when permitted to experience the dental visit on their own and in an
environment designed for children.
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.
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 finance charge of 1.5% will be added to your account each month
until paid. We will be glad to send a refund to you once insurance has paid
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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