We handle the filing of your insurance forms for any insurance benefits for which you may be eligible with your insurance company, so it’s important you update us of any changes. All insurance benefits will be paid by the insurance company directly to you. Therefore, the entire amount for the procedures performed is due at the time of service and must be paid in full for services to commence unless arrangements for financing have been made. If you haven’t used dental insurance before, most insurance company contracts still require significant out-of-pocket payments by the patient, so you should expect that insurance payments you receive will be less than the amount you paid us at time of treatment for any dental procedure “covered” by your insurance.
If you’re covered by an “indemnity” or PPO insurance plan, you usually may visit any dentist that accepts insurance (many dentists don’t by the way) and receive your benefits, but you’re responsible to pay the dentist’s regular fee regardless of the amount your insurance pays. We accept all indemnity and PPO plans. Both types of plans have an annual deductible, annual maximum, and a contractual amount they will pay after co-pays and deductibles for each procedure. This amount is dependent on what your employer negotiates and pays for your premium to the insurance company – thus, insurance payments vary by company with the same insurance carrier. The amount is labeled “usual & customary charge” by the insurance company to make it sound like a standard for the area even though it’s an arbitrary amount that is different for each company based upon the premium paid by the employer. Don’t be fooled by the insurance company or your HR department into thinking that it’s all you should pay; rather, it’s all your company is willing to pay to have paid to you toward your dental health. The use of the “usual & customary” instead of “your company’s contracted payment rate” is a bit of a smoke screen to mislead patients by insurance carriers and employers.
DMO plans are like “in-network” PPO plans, but benefits can be paid only to dentists who are members of the network. Therefore, with a DMO plan, if you go to a non-network dentist you will get no insurance benefits at all. Interestingly, DMO plans pay participating dentists a fee if you don’t go see them in a given month, which is often more than they pay the dentist if you do see them. In fact, DMO dentists lose money if you go to them for X-rays, cleanings, diagnoses, or fillings and don’t do anything else because they are not paid by the insurance company when they provide those services. Given this crazy business model for DMOs’, our office is not a member of any DMO plan. Instead, we offer patients without insurance, and those stuck in DMO plans, our own discount subscription dental plan.
Please contact us to answer any questions about your specific insurance plan type.
Preferred Patient Membership Plan
We offer a comprehensive subscription discount plan that includes coverage for every procedure we offer, including cosmetic procedures never covered by insurance plans. Please follow this link – “Preferred Patient Membership Plan” – to learn the full details
It is our goal to help you get the smile you want and the dental treatment that you need, regardless of the cost. Unfortunately, we are not a bank – but we have partnered with some excellent companies to provide you with options should you care to spread payment over time. Choices abound based upon the amount financed and the number of payments selected.
Our staff will be happy to assist you with the application process, which can be done quickly from our office.
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