Our Practice Policies and Guidelines

Appointment and Financial Guidelines - Dental Insurance Guidelines

We believe in the value of clear communication, as well as mutual understanding and respect. We believe that our patients would like to know and understand our appointment, financial, and insurance guidelines in advance of their treatment. You will find these guidelines outlined below, however we are always happy to discuss your proposed treatment and any of our practice guidelines with you personally.

Appointment Guidelines:

It is our desire to provide high-quality dental care and individual attention for you in a timely manner. We pre-plan and prepare for your visit and hope you have done the same. Your appointment time has been reserved especially for you and we strongly encourage all patients to keep their appointments. When time is lost due to last-minute appointment changes, other patients in need of treatment cannot be seen and your treatment is delayed. Should any scheduling changes be required, we require at least 24 hours advance notice to avoid a cancellation fee.

We make every effort to remind patients by telephone or email prior to their appointment but please do not depend on this courtesy. We have found that with the recent popular use of answering machines, cell phones, pagers, and voice mail, some of our patients are not receiving these reminder calls. It is always helpful, if you use such devices, for you to return our call to confirm that you have received our message. If we are unable to contact you directly, your appointment card or your appointment phone call will serve as confirmation of your appointment and implies your obligation to be present at that prearranged date and time.

Financial Guidelines:

New Patients:

Please supply complete insurance and account information to our office before your appointment so that we can verify your insurance benefits before treatment. Until we have received and verified the necessary account and insurance information, all treatment rendered on the first visit must be paid in full at the time of service. We happily accept cash, personal checks, or credit cards (MasterCard, Visa, and Discover.)

Established Patients:

All of our fees or co-pays are due and payable at the time treatment is rendered. We will be happy to keep a credit card on file as a courtesy to our patients. For fees and co-pays over $500, we have several financial options available. For major treatment our staff will be happy to provide several financial options including outside financing through CareCredit for those who qualify.

Emergency Treatment:

Emergency appointments are scheduled around our daily reserved patient appointments. We will try our best to get emergency patients in and treated as soon as possible. Our number one goal is to get you in and out of pain. Due to these circumstances our office will not be able to verify insurance benefits or limitations on your account before completing this unreserved treatment appointment. In order to schedule emergency treatment we ask that you cover the full fee for the emergency procedures at the time of service. If you have insurance, we will be happy to file it for you and credit back or apply any credit due at your request upon receipt of the insurance payment.

Dental Insurance Guidelines

We are glad you have dental insurance to provide you with partial assistance in affording your dental care. We are happy to assist you in filing the necessary forms to help you receive the full benefits of your dental insurance coverage as a courtesy to you at no additional cost. Dental insurance is different than most medical insurance plans and it is important to be aware of the following

• The insurance relationship constitutes an agreement between the carrier, the employer, and the patient. Our dental office is not a party to that contract. As such, we can make no guarantee of estimated coverage or payment.
• Insurance companies base the amounts they pay on restrictive fee schedules, regardless of what the actual fee might be. Our fees are often, but not necessarily, covered in full by the maximum allowance determined by your carrier.
• Not all dental services that are necessary for proper dental health are a covered benefit in all contracts. This depends on the kind of plan you and/or your employer has purchased.
• Deductibles and co-payments are built into most plans and their required payment is strictly regulated by state law. Your Employee Benefits or HR Director can usually help you become familiar with your plan and its restrictions.

Our responsibilities:

1. Complete insurance claim forms and submit to your carrier within 24 hours of treatment
2. Use current American Dental Association coding for correct reporting of procedures.
3. Accept direct payment from your carrier and keep track of balances.
4. If necessary, re-file your insurance a second time within a 30-60 day period.

Your responsibilities:

1. To pay fees not covered by your plan at the time of treatment or as otherwise arranged.
2. To provide our office with necessary information concerning your insurance coverage to allow correct filing of claims.
3. To understand that your plan is a contract between you, your employer, and the insurance carrier. Our office will do all we can to facilitate claims payment, but we do not have the power to force your insurance company to pay.
4. To pay any account balance not paid by insurance after 60 days and after 2 billing attempts.

Thank you for choosing our office for your dental needs. Please know that we will do everything possible to see that you receive the full benefits of your insurance policy.

Remember: By submitting your insurance information with our practice you hereby authorize payment of the insurance benefits otherwise payable to you to be made directly to this dental office. You understand that any insurance coverage estimate given to you by this office is not a guarantee of actual insurance payment. You also understand that you are ultimately responsible for all charges incurred for dentistry performed upon yourself or your dependents in this dental office. You have authorized the release of your dental/medical histories and other information about your dental treatment to third party payers.