insurance ACCEPTED

We are participating providers with these companies:

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• Delta Dental

• Guardian

• Cigna

 

In most cases, you can look up your benefits online or feel free to call our office and we can help you. We can only assist in estimating your portion of the cost of treatment.

 

Please remember you are fully responsible for all fees charged by our office regardless of your insurance coverage.

 

Some information about dental insurance:

 

Please understand that we file dental claims as a courtesy to our patients. We do not have a contract with your insurance company, only you do. We are not responsible for how your insurance company handles its claims or for what benefits they pay on a claim. We can only assist you in estimating your portion of the cost of treatment. We at no time guarantee what your insurance will or will not do with each claim. We also cannot be responsible for any errors in filing your insurance. Once again, we file claims as a courtesy to you.

 

Fact 1- No Insurance Pays 100% Of All Procedures

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Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 90%-100% of all dental fees. This is not true! Most plans only pay between 50%-80% of the average total fee. Some pay more, some pay less. The percentage paid is usually 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.

 

Fact 2- Benefits Are Not Determined By Our Office

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You may have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist’s actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist’s fee has exceeded the usual, customary, or reasonable fee (UCR) used by the company.

 

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable, or well above what most dentists in the area charge for a certain service. This can be very misleading and simply not accurate.

 

Insurance companies set their own schedules, each company uses a different set of fees they consider allowable. These allowable fees may vary widely because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a level they call the “allowable” UCR Fee. Frequently, this data can be three to five years old and these “allowable” fees are set by the insurance company so they can make a net of 20%-30% profit.

 

Unfortunately, insurance companies imply that your dentist is “overcharging”, rather than say they are “underpaying”, or that their benefits are low. In general, the less expensive insurance policy will use a lower usual, customary, or reasonable (UCR) figure.

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Fact 3- Deductibles

You are responsible for any deductibles or co-pays your insurance may have.