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Our office offers
convenient hours for your family:
Monday: 7-5
Tuesday: 7-5
Wednesday: 7-5
Thursday: 7-4
Friday: 7-3
Saturday: 7-4 (once a month) |
Do I stay with my child
during the visit?
We are always happy to have a parent accompany their child back for
all phases of treatment. It has been our experience that children
feel more secure and are better able to cooperate when they have a
parent with them. It offers us the opportunity to provide more
education and information. We also enjoy the benefit of getting to
know the parents better.
We do, however, ask that only one adult accompany the child to the
treatment area. Parents are welcome to trade off during the
appointment if they like. If there are too many people in the
treatment area it can be distracting to your child as well as the
others. It can also be difficult for the child when they are
receiving instructions from us as well as two parents. If the second
parent has questions, we will meet with them in our consultation
room at the end of appointment.
What about finances?
Payment for professional services is
due at the time dental treatment is provided. Every effort will be
made to provide a treatment plan which fits your timetable and
budget, and gives your child the best possible care. We accept cash,
personal checks, debit cards and most major credit cards.
We are participating providers of Delta Dental, United Concordia,
Tri Care and NM Medicaid. We also accept all other insurances. Some
insurance companies require that you see a participating dentist
within the network for the services to be covered, or to be covered
at the highest level. Please contact your insurance to see if our
services would be a fully covered benefit under your dental plan.
The adult bringing the child to the appointment and approving
dental treatment is responsible for paying for the treatment that
day. Often, in custody or divorce situations, one parent is
responsible for paying for health care, this needs to be worked out
between the two parents. Our office will bill the parent who
consented to treatment and accompanied the child to the appointment.
Our office policy
regarding dental insurance
If we have
received all of your insurance information on the day of the
appointment, we will be happy to file your claim for you. If you
have not paid your balance within 90 days re-billing fee of 1.5%
will be added to your account balance each month until paid. You must
be familiar with your insurance benefits, as we will collect from
you the estimated amount insurance is not expected to pay. By law
your insurance company is required to pay each claim within 30 days
of receipt. You are responsible for any balance on your
account after 30 days, whether insurance has paid or not. If you
have not paid your balance within 60 days a re-billing fee of 1.5%
will be added to your account each month until paid. We will be glad
to send a refund to you if your insurance pays us.
PLEASE UNDERSTAND that we file dental insurance as a courtesy
to our patients. We do not have a contract with your insurance
company, only you do. We are not responsible for how your insurance
company handles its claims or for what benefits they pay on a claim.
We can only assist you in estimating your portion of the cost of
treatment. We at no time guarantee what your insurance will or will
not do with each claim. We also can not be responsible for any
errors in filing your insurance. Once again, we file claims as a
courtesy to you.
Fact 1 - 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 how much you or your employer has paid for
coverage, or the type of contract your employer has set up with the
insurance company.
Fact 2 - BENEFITS ARE NOT DETERMINED BY OUR OFFICE
You may have noticed that sometimes your dental insurer reimburses
you or the dentist at a lower rate than the dentist's actual fee.
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.
Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED
When estimating dental benefits, deductibles and percentages must be
considered. To illustrate, assume the fee for service is $150.00.
Assuming that the insurance company allows $150.00 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 $100.00. The plan then pays 80% for this particular
procedure. The insurance company will then pay 80% of $100.00, or
$80.00. Out of a $150.00 fee they will pay an estimated $80.00
leaving a remaining portion of $70.00 (to be paid by the patient).
Of course, if the UCR is less than $150.00 or your plan pays only at
50% then the insurance benefits will also be significantly less.
MOST IMPORTANTLY, please keep us informed of any insurance
changes such as policy name, insurance company address, or a change
of employment
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