We are committed to providing you with the highest quality healthcare. Navigating insurance can sometimes be complicated, but we want to make the process as smooth and transparent as possible. Our practice is pleased to be in-network with a wide range of insurance providers. We do our best to accept many major insurance plans to ensure our services are accessible to our community.

Your Responsibility: Verifying Coverage

While we strive to verify coverage as a courtesy to our patients, it is ultimately the patient's responsibility to verify their specific benefits and coverage with their insurance carrier before each appointment.

Insurance plans and coverages can change frequently, often without notice. Confirming your benefits ensures that you understand what services are covered, your deductible status, your co-pay, and any potential out-of-pocket expenses you may incur on the day of your visit.

Why is this necessary?

We are often at the mercy of insurance verification systems. These systems sometimes provide limited or preliminary information. A quote of benefits from the insurance company is not a guarantee of payment.

• System Limitations: Real-time data from insurance portals can sometimes be delayed or inaccurate.

• Plan Variations: Even within the same insurance company, employer plans vary widely in covered services.

• Changes: A service covered today might not be covered next month if your employer changes the plan details.

Verifying your benefits ahead of time helps prevent unexpected bills later.

How to Verify Your Benefits

Before your next visit, please contact your insurance provider directly using the member services phone number on the back of your insurance card.

Ask them specifically:

• "Are you in-network with [Your Doctor's Name/Practice Name]?"

• "Is the specific service I am receiving today ([e.g., preventative care visit, procedure code XYZ]) covered under my plan?"

• "Have I met my deductible or my out-of-pocket maximum?"

• "What will my co-pay or co-insurance be for this visit?"

The usual payment policy for our dental practice that accepts many insurance plans requires patients to pay their estimated portion (co-pays, deductibles, and co-insurance) at the time of service. 

Here are the key aspects of a typical payment policy:

• Payment at Time of Service: The patient is expected to pay their estimated financial responsibility, such as co-pays, deductibles, and the non-covered portion of the bill (co-insurance, usually 20-50%), when the services are rendered.

• Insurance as an Aid: Dental insurance is generally viewed as an aid to help with costs, not a guarantee of 100% coverage. Most plans cover procedures at 50% to 80% of a pre-established "allowed" fee.

• Estimates, Not Guarantees: The dental office will provide an estimate of the patient's portion based on the limited information provided by the insurance company's systems. This estimate is not a final guarantee of payment from the insurer.

• Patient Responsibility for Verification: It is the patient's ultimate responsibility to confirm their specific benefits, deductibles met, and coverage details with their insurance carrier prior to treatment.

• Filing Claims as a Courtesy: The practice typically submits the insurance claim on behalf of the patient as a courtesy. However, this does not transfer the financial obligation from the patient to the insurance company.

• Balance Billing: If the insurance company pays less than the estimated amount, the remaining balance is billed to the patient. Any claim unpaid after a certain period (e.g., 60 days) typically becomes the patient's direct responsibility.

We Are Here to Help

We understand insurance can be confusing. Our billing team is available to assist with general questions and can help guide you through the process. However, the final confirmation must come from your insurer.

Thank you for your understanding and cooperation as we work together to manage your healthcare needs.