We offer discounts to cash paying patients without insurance!
You can pay for your office visits and any treatments by cash, credit or debit card (sorry, no checks), at the time of treatment. We also accept most major dental insurances.
For your convenience, we are pleased to accept CareCredit — a line of credit that offers no interest payment plans. No interest is assessed if the balance is paid within the promotional period. Otherwise interest is assessed from purchase date. Minimum monthly payments required. Subject to credit approval.
We accept Delta, Aetna, Cigna, Metlife, Guardian, Blue Cross/Blue Shields, Medicaid, CHP+ and many others. If your insurance carrier is not listed, please call, and we’d be more than happy to answer any insurance questions.
If we have received all of your insurance information on the day of the appointment, we will gladly file an insurance claim for you. However, you must be familiar with your insurance benefits, as we will collect your estimated co-pays on the day services are rendered. We file all insurance claims electronically, so your insurance company will receive each claim usually within a few days to a week. You are responsible for any balance on your account after recieving payment from your insurance company, whether insurance has paid full estimate or not.
Most importantly, please keep us informed of any insurance changes such as policy name, group number, insurance company address, or a change of employment.
Dental Insurance Facts
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 the type of contract your employer has set up with the insurance company.
Deducibles and co-payments must be considered.
When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $200.00. Assuming that the insurance company allows $200.00 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 $150.00. The plan then pays 80% for this particular procedure. The insurance company will then pay 80% of $150.00, or $120.00. Out of a $200.00 fee they will pay an estimated $120.00 leaving a remaining portion of $80.00 (to be paid by the patient). Of course, if the UCR is less than $200.00 or your plan pays only at 50% then the insurance benefits will also be significantly less.
Benefits are not determined by our office.
You may have noticed that sometimes your dental insurer reimburses the dentist at a lower rate than the dentist’s actual fee (out of network). 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.
Out of Network Benefits
Most insurance plans have both in network and out of network benefits, this is why its crucial for you to know how your insurance works. We are in network with most insurances, but occasionally there are a few whom we are out of network with. What this simply means is as long as you have percentage benefits and not a discount plan or an HMO plan, we will gladly submit claims to your insurance company. Patient estimates will vary with out of network benefits simply because, to put in lamen terms, we submit claims using UCR fees, your insurance only pays their allowable fees, and you’re responsible for the difference. However we will always try and give the the most accurate estimate as we possible can, and we will always tell you prior to your appointment whether we are in network or out of network with your insurance carrier.