Our commitment is to provide you with the best possible care. If you have dental insurance, we’ll be happy to assist you in processing the claim, so that you will receive your optimal allowable benefits. In order to achieve these goals, we need your assistance, and your understanding of our payment policy.
Payment/co-payment for services is due at the time services are rendered unless payment arrangements have been approved in advance. We accept cash, checks, MasterCard, Visa, American Express , CitiHealth Card and Discover. In most instances, we will accept assignments of insurance benefits from your insurance carrier.
In all cases involving lab work such as crowns, bridges and dentures, we require at least 50% down payment at the start of the treatment.
We will gladly discuss your treatment plan and answer any questions relating to your insurance. However, please keep in mind that:
- Your insurance coverage is a contract between you, your employer, and the insurance company. We are not a party to that contract.
- Our fees are considered to fall within the acceptable range by most insurance companies. Nevertheless, some insurance companies choose to set up their arbitrary schedule of fees, which bears no relationship to current standards and cost of care in this area.
- Not all services are covered benefits in all contracts. Some insurance companies arbitrarily select certain services they will “downgrade” or not cover.
We would like to emphasize that as a dental care provider, our relationship is with you, the patient, not your insurance company. While the filing of claims is a courtesy that we extend to our patients, all charges are your responsibility from the date the services are rendered.
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The following table outlines the broad parameters of the major types of dental insurance.* Please do not hesitate to contact us if you have any questions.
|
Indemnity |
PPO |
HMO |
|
|---|---|---|---|
|
Payment |
Providers are indemnified or reimbursed for services. | Providers are paid on the basis of a discounted fee schedule. | Providers are paid a dollar amount per member per month regardless of services rendered. |
| Benefits | The levels and coverage are defined by a contract. | Enrolled members receive services at a reduced cost when the services are delivered by a preferred provider. | Enrolled members receive comprehensive benefits when care is provided by a plan provider. |
| Patient’s freedom of choice | Patient chooses his or her own doctor; the most freedom of choice. | Patients are not locked into one dentist but pay more for care from a non-preferred provider. | Patients are locked into designated providers; least freedom of choice. |
| Utilization | May or may not be controlled by the carrier. | Less controlled than an HMO. | Providers receive a financial incentive to control utilization. |
| Cost to patient | Most expensive. | Less expensive than an indemnity plan. | Least expensive. |
*. Smith DM. Understanding the patient’s perspective on insurance. Dent Practice & Finance 1995, 9/10:54-55.
858-518-2354
