Important Information for Patients Covered by an Insurance Policy
Your insurance policy is a contract between you and your insurance company. We are not party to that contract. However, it is our pleasure to assist you in maximizing your insurance benefits by completing and submitting claim forms to your insurance company. We do ask that you be as familiar as possible with your own dental plan and be responsible for monitoring all benefits and carrier payments pertaining to your annual maximum dental benefit. We realize that dental insurance can be quite overwhelming and confusing, and we will do our best to estimate insurance benefits upon your request. Please understand that it is only an estimate based upon information available to us at that time and you are ultimately responsible for any and all amounts not paid by your insurance. At this time we do not process claims to secondary insurance. We will be more than happy to provide you with the information necessary to do so.
Our treatment plans are always based on what the doctor believes is the best way to achieve and maintain your optimal dental health. Unfortunately insurance companies do not base benefits on this standard. Your benefits are based on the policy your employer buys from your insurance company.
When it comes to more expensive treatment plans, even if recommended treatment is a covered benefit, it is advised to submit what’s called a “Pre-Treatment Estimate”. A pre-treatment is sent to your insurance company to find out what they will pay on a specific procedure. The pre treatment estimate is valid ONLY on the day it is processed. It is only a guideline to payment. Benefits may have been exhausted prior to performing the pre treated procedure, the policy may have changed, or you may no longer be covered due to leaving your job. Even if the pre estimate clearly states that a procedure will be covered, the patient may learn later that the estimated benefit will not be paid after all. This is rare, but it does happen. When it does, the patient is still obligated to pay the entire bill themselves.