As a courtesy to our patients, we will be happy to complete and forward insurance forms relative to dental treatment, and we will do so without charge. We are able to process claims to most PPO dental plans. We do not participate with any HMOs.
However, in order to avoid misunderstandings, please read carefully and understand the following policies in regard to dental insurance benefits.
Our professional treatment is rendered to you, not to the insurance company; you are directly responsible to us for the obligation of payment of treatment. You can then be reimbursed by your insurance company, according to the terms of that policy. Although we can file claims to any carrier, this office is only in-network with Cigna, Delta Dental, Guardian, Principal and United Concordia.
Please understand that the amount to be paid by your particular policy is pre-determined and agreed to by your employer and the insurance company. If you have any questions about the amount the plan will pay or the treatments your plan will cover, you should refer these questions to your employer. At your request, this office will provide all pertinent information to your insurance company and we will do our best to help you derive the maximum benefits available. However, we are not responsible for determining what those benefits are to be. We also do not check on the status of claims (unless with the above-mentioned carriers), that is the responsibility of the subscriber.
Some policies request a “pre-authorization” or “pre-determination” before treatment begins. At your request, we will submit a treatment plan for review by your insurance company.
Please remember that dental insurance is designed to assist people to obtain dental care and rarely covers more than 1/3 to ½ of the total cost of service. There may be a deductible, a co-insurance factor, and a yearly maximum to be considered.
Most policies cover what they consider a “usual and customary fee.” However, the insurance company sets these fees, and they are not always the same as the fees that may be charged in this office.
All these factors may combine to reduce the benefits you will ultimately receive. We will do our best to provide documentation within the structure of your particular dental plan. However, ultimate responsibility for payment is yours and financial arrangements must be defined before dental treatment can begin.