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 it. Other patients who need 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 son or daughter through the dental visit. If your child is older than the age of 3, however, we recommend you allow him or her to accompany our staff through the dental experience.
Studies and experience have shown that most children above 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 that 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 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, because 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 carrier 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.
Our dental practice also accepts Denti-Cal insurance as a backup or secondary plan, so if you unexpectedly lose your job or insurance, you can still schedule a dental appointment. You’ll never have to leave our practice as a result of losing insurance or your job. We also accept PPO dental insurance, which helps you save money on fees that other offices may charge if they don’t accept PPO plans.
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; at no time can we guarantee what your insurance will or will not do with each claim. We also cannot 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 believe their insurance pays 90% to 100% of all dental fees. This is not true! Most plans only pay between 50% and 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 the 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% to 30% profit.
Unfortunately, insurance companies imply that your dentist is “overcharging” rather than acknowledge 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, which leaves 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 IMPORTANT, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.