Insurance Info

Dealing with dental insurance compaines can be a challenge.

Hence as a courtesy, we offer direct billing to your insurance company as a service to all our patients.

A dental benefit plan is a contract between you and your insurance company.  Your dental plan coverage is not based on your individual dental health needs as it may be a group plan through your work.  With this in mind and the tendency for plans to change, we ask that you become familiar with your plan.

Even if your plan covers 100% -  it may not!!

The Basics

Before coming in for your first visit it is a good idea to know:

  • Your annual maximum (the amount you are allocated per year for general dental treatment).
  • Your recall/recare interval (how often you can come in for your checkup & cleaning).
  • Your coverage percentage (what percentage of the bill your policy will pay**).

** Your insurance has their own fee guide which does not match up with our fee schedule.  As a result there may still be charges left over even if your plan stipulates 100% coverage.

Direct Billing

Our office sends off your claim electronically to your insurance for you (if your insurance company has this facility).  Within a few minutes we may receive an "explanation of benefits" that informs us what portion insurance is paying.

Your charge at the time of the appointment is the balance of  what your plan does not cover.

Occasionally, the electronic system is busy and your claim will end up in an electronic queue.  In such case we still only charge you a portion (estimate) and let you know if further payment is required after insurance pays us.

Sometimes the policy or the insurance plan does not pay us (the provider) but reimburses you (the subscriber).  Hence, it becomes necessary to pay the full cost of the treatment.  We can still assist in filing the claim for you or provide you with the claim form to submit yourself.