|
Home |Our
Office |Our
Services | Staff | Patient
Education|
INSURANCE
POLICY
Our
Insurance Letter
Medical
insurance is insurance. Dental insurance is just a
benefit plan.
 |
Most insurance companies are accepted.
|
 |
We ask that you provide us with your dental health insurance information
BEFORE your appointment. This is so we can provide you with more accurate dental
coverage estimates.
|
 | We will file your insurance claims for you at no charge.
Since we deal with over 200 dental insurance plans will try to give
you an guestimate of what your dental insurance MAY cover. Please
remember most insurance companies do not tell you that
their usual and customary fees are below what is reasonable
an normal for quality dental services.*The
insurance company will not tell either one of us what
they will pay. |
 | Often plans
tell participants they will be covered "up to 80% or
100%" but do not clearly specify 80% or 100 % of what
fee schedule, what annual maximums really are or what
their plans limitations are. Insurance companies do NOT
cover all dental services |
 |
You may receive
notification from your insurance company stating dental fees
are "higher than usual and customary". An insurance company
surveys a geographic area, calculates an average fee and
then takes that fee and considers it customary. Included in
this survey are discount clinics and managed care
facilities, which bring down the average. Most doctors in
private practice will have fees, which are defined as "above
usual and customary". |
Why
Doesn't My Insurance Cover This?
 |
If you have
any questions about your insurance, please contact them directly. Medical
expenses are covered way differently with
medical insurance than dental insurance.
Medical is
an issue of indemnity and dental is simply a
prepaid process. |
 |
Each patient is responsible for his or her deductible,
co-pay, and any procedures not covered by your insurance at time
of service.
We are not a party to
the contract between the employer and insurance
company. We
aren't a "contracted provider".
|
 |
Insurance
companies almost always notify patients of a
payment before sending this payment to a
dentist. If there is a remainder that the
insurance company did not pay than we will bill
you for the remaining balance, however, there is
a billing charge after 30 days
of nonpayment.
|
 | You understand that we will not be
responsible for knowing the various scenarios in which
your insurance does not pay for whatever reason. Such
scenarios include such things as pre-existing conditions,
waiting periods, x-rays which can only be paid on every so
often, less costly alternative provisions, required
pre-authorizations, etc. Your insurance company may use
these and other reasons for avoiding payment of your
claim. We will not be responsible for knowing these
various intricacies of your particular insurance contract.
You will need to be responsible for knowing all these
details and advising us because insurance companies refuse
to provide us with these details. |
 |
Insurance companies that we do not accept, we will gladly
provide a doctor statement that will give you all the information you need to
meet your insurance company’s requirements for filling claims. You will
pay for services at time service is rendered and than you will directly
receive a check from your dental insurance company. |
 |
Call the New York State
Dental Association at 1-518-465-0044 for a free brochure
entitled, "Are You Missing Out on the Dental
Benefits You Deserve?"
|
Insurance Terms:
Dental Benefits Terminology
I Don't Have Enough Money
to Fix My Teeth
In 1960, the average maximum benefit paid by insurance
carriers was $1,000 per year. In 2005, the average is
still approximately $1,000 per year. Can this be true?
Yes! An ever-increasing number of patients cannot gain access
to needed dental services because the maximums have not even
kept pace with inflation. Is there a solution? Absolutely.
A Blueprint and Direct
Reimbursement.
A "Blueprint" is a complete and full treatment plan, customized
to your wants and needs, that will allow you to phase in
ideal treatment over a period of time leading to the
ultimate goal of ORAL HEALTH.
"Direct Reimbursement" dental benefit is a simple reimbursement
system that preserves your right to choose treatment with
minimal paperwork and no preliminary authorizations. Employers
who select this alternative benefit plan can save money and
purchase plans that provide cost-effective services for
employees.
*Contemporary Esthetics
and Restorative Practice, G I Johnson, July 2001 pg 44
Why
Doesn't My Insurance Cover This?
September 28, 2008
Back
Financial
Information Office
Information
Home |
|