Please understand that we file dental insurance as a courtesy to our patients. If we have all of your insurance information on the day of the appointment and the ability to verify your coverage, we will be happy to file your claim for you. You must be familiar with your insurance benefits as we will collect from you the estimated amount insurance is not expected to pay.
Dental insurance is actually a benefit based upon a contract made between your employer and an insurance company. With dental benefits, your policy covers a maximum dollar amount. It is simply a limited benefit and in no way is designed to “cover” your entire out of pocket expenses. Therefore, we can only estimate, not guarantee, what your insurance company will pay to the best of our ability at that time. The percentage paid is 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. Usual and customary: an insurance company surveys a geographic area, calculates an average fee, takes 80% of that fee and considers it customary. Included are discount clinics which are reflected in their “average.” Remember the amount a plan will pay is determined by how much the employer paid for the plan. You get back only what your employer has put in, less the profits of the insurance company.
Most importantly, please keep us informed of any insurance changes such as policy name, insurance company address or a change of employment. Insurance benefits change throughout the year based on the renewal date for that particular employer.