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Insurance
We file on most dental insurance at no charge, however, patients are responsible
for their co-pay at the time of service. At the present time, we are a
provider for Delta Dental.
Payment Plans
1. We accept Visa, MasterCard and Discover Card.
2. Short Term Pay-Out.
3. No-interest payment plan for qualified individuals.
4. We are pleased to offer Capital One Healthcare Finance to our patients. Capital One Healthcare Finance is a convenient, no initial payment, low monthly payment plan for dental treatments of $1,000 to $25,000. Offering Capital One Healthcare Finance allows us to make the smile you've always wanted affordable.
What You Should Know About Our Fees and Insurance
We strive to keep our fees as low as possible for the benefit of everyone.
We do not establish our fees on the basis that insurance companies will
pay them. As a benefit to you, we will accept insurance assignment on
procedures other than initial consultation visits. Any balance remaining
on your account after insurance payment has been received is your responsibility.
We hope you find the following information useful. Insurance matters are
often complicated, so if you have any questions regarding your coverage,
please feel free to talk to Dr. Keith or our financial coordinator.
Our office establishes policies for payments of fees and acceptance of
insurance reimbursement, but the more you know and understand about your
insurance plan the better our relationship will be.
Please ask our staff about financial arrangements and payment options
for extended treatment. For your convenience we accept Visa, Mastercard,
Discover, checks and cash.
Pre-Estimates and Explanation of Benefits
Before any treatment is rendered, Dr. Keith will provide you with a pre-treatment
estimate which, will include the costs for the procedure. This pre-estimate
will be sent to your insurance company if you wish and they will let you
know what your insurance policy covers. In today's market, dental insurance
policies vary a great deal depending on what your company purchased. A
problem common to most dental plans is that unlike medical insurance they
have a very small yearly maximum allowance. Most dental plans have a yearly
maximum of $1 000.00 to $1,500.00 which unfortunately does not cover much
in today's dollars. In 1970, the average yearly maximum allowance at that
time was $1,000.00. A thousand dollars bought something years ago but
unfortunately dental insurance allowances have not kept up with inflation
even though the premiums they ask you to pay have skyrocketed.
HMO'S and PPO'S
Some dental insurance plans are not insurance at all - they are medical
PPO's or HMO's with a dental rider. These plans are usually a list of
fixed fees for certain, (but not all) procedures, or a fixed percentage
reduction in the fees charged. In these plans it is usually the patient
who pays the whole treatment fee, but at the reduced rate. This is the
worst kind of benefit, because it costs the patient the most out of pocket,
but the insurance company pays little or none.
Usual, Customary, Or Reasonable (UCR)
Another way that the insurance companies limit their coverage is a term
called UCR. Typically, the insurance company and your employer determine
the reimbursement level that varies from 50% to 90% of what dentists in
the area charge. For a particular procedure that most dentists charge
$550.00, for example, if the employer wants to keep costs down, one option
is to buy a plan that reimburses at a reduced level. In other words, instead
of reimbursing at $550.00 or higher, it may only reimburse at $450.00
or less on the same procedure. (percentage of$450, instead of percentage
of$550).
The insurance company calls $450.00 their "UCR Fee" so this reduces
the cost of the insurance policy to your employer. If our charge is $550.00
(the amount that most dentists charges), the carrier is likely to state
that our fee was above the "Usual, Customary, and Reasonable" fee. This
comment would naturally make you think that our fee is higher than most,
which is not the case. Although this can be a common misconception, it
would be more accurate to state that your employer chose a plan that does
not reimburse at the level most dentists charge in the area. The patient
is responsible for more "out of pocket" expense because their coverage
was reduced to lower the premiums of the policy.
It is also important to realize other employers with the same insurance
company (or even those, with a different carrier) would consider the $550.00
a "reasonable" fee. Our office strives to produce excellence on a daily
basis. In many instances there is nothing "usual or customary" about how
you are treated while under our care. Our fees are based on the skill,
care, judgment and office environment that it takes to consistently provide
you with the best care possible anywhere in the world.
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