Dental insurance is a growing part of our dental health picture. Coverage varies greatly. Although we are happy to assist you, please know that it is your responsibility to understand your policy.
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Insurance policies are contracts between the insurance company and you (or your employer). All financial arrangements for services rendered are made with you, not the insurance company. We will collect your co-payment based on estimates of standard insurance plans. We file all insurance claims electronically on the day of your child's visit to help facilitate any reimbursements to which you are entitled. |
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Insurance companies are required by law to pay each claim within 30 days of receipt of the claim. You are responsible for any balance on your account after 30 days, whether insurance has paid or not. We will be glad to send you a refund once insurance has paid us. |
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Dental insurance is intended to be an aid in paying for dental care. Most dental plans pay between 50% - 80% of the total fee. The percentage paid is often determined by how much your employer has paid for the coverage, or the type of plan set up with the insurance company. At times you may be notified by your insurance company that its reimbursement rates are lower than actual fees. Often insurance companies will state that your reimbursement has been lowered because the dentist's fees exceed usual and customary rates (UCR). This is misleading. There are hundreds of insurance companies that offer dental insurance, and each company sets its schedule of what they consider to be allowable. These allowable rates may vary greatly. The allowable UCR is arbitrarily established by data collected by the insurance company. Estimate of Benefits (EOB) reports you may receive may imply that your dentist is charging higher fees for your area rather than saying that they are "underpaying" or that your plan benefits are lower than usual and customary. |
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The American Academy of Pediatric Dentistry