Dental insurance is a contract between an employer and an insurance company to help cover the cost of dental care. While dental insurance can be a helpful aid in receiving dental treatment, it is important to understand that it does not cover 100% of all procedures. Most plans only pay between 50%-80% of the average total fee for a covered procedure, and this percentage can vary depending on the plan chosen by the employer and individual.
It is also important to note that our office does not determine the benefits of your dental insurance. Insurance companies set their own schedules and allowable fees for treatments, and these fees can vary widely. Additionally, insurance companies may use outdated fee information to set their “allowable” fees, which can result in lower reimbursement rates for patients.
When estimating your dental benefits, it is important to consider factors such as deductibles, co-payments, and exclusions or limitations in your policy. Our office will help provide you with the information necessary to help you receive your maximum benefit, but it is ultimately your responsibility to understand your insurance coverage and benefit limits.
Please be aware that you are responsible for any portion of dental services not covered by your insurance at the time of treatment. This may include deductibles, co-payments, or certain procedures not covered by your insurance company. We will file your insurance claim and accept the assignment of benefits, but our relationship is with you, the patient, and not with your insurance company.
In some cases, insurance carriers may not allow for reimbursement directly to our office. In these instances, you will be responsible for the full cost of each visit at the time of treatment, and the insurance company will send the reimbursement check directly to you. We will electronically file your claim to help expedite your reimbursement.
Please note that the parent or guardian bringing a child to our office is legally responsible for payment of all charges.