FINANCIAL Policy
Payment for professional services is due at the time dental treatment is provided. Every effort will be made to provide a treatment plan which fits each patients timetable and budget, and gives each patient the best possible care. We accept cash, personal checks, debit cards, HSA cards and most major credit cards
Dental Treatment beyond $500: One-half (1/2) the cost of the treatment must be paid on the day an impressions is taken. This is necessary because our office must pay the lab bills when dental materials are ordered, not when they are completed. The remainder of the cost of the treatment is due on the day of delivery of crown, bridge, denture or partial.
Dental Treatment beyond $500: One-half (1/2) the cost of the treatment must be paid on the day an impressions is taken. This is necessary because our office must pay the lab bills when dental materials are ordered, not when they are completed. The remainder of the cost of the treatment is due on the day of delivery of crown, bridge, denture or partial.
Dental Insurance Policy
We are not currently accepting any medical assistants DELTA DENTAL MEDICARE ADVANTAGE, UNITED HEALTH CARE, FHC with Security Health Plan, BadgerCare, or Forward Insurance.
If we have received all of your insurance information on the day of the appointment, we will be happy to file a patient's claim. Each patient must be familiar with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay. By law each patient's insurance company is required to pay each claim within 30 days of receipt. We file all insurance, so the insurance company will receive each claim within days of the treatment. Each patient is responsible for any balance on your account after 30 days, whether insurance has paid or not.
PLEASE UNDERSTAND that we file dental insurance as a courtesy to our patients. Our office does not have a contract with the insurance company, that contract is made with the patient/subscriber of the policy . Our office is not responsible for how the insurance company handles its claims or for what benefits is paid on a claim. Our office can only assist the patient in estimating the portion of the cost of treatment. At no time can our office guarantee what the insurance will or will not pay with each claim. In addition our office also can not be responsible for any errors in filing the insurance. Once again, our office file claims as a courtesy to you.
Pre-treatment Authorization: Some insurance companies recommend an estimate of the work to be done and the fees to be charged before determining their benefits to you. If so, our office will provide you with the pre-treatment fee estimate. In this case, it will be up to the patient to determine if he/she wishes to proceed with treatment before the insurance benefit is determined.
If we have received all of your insurance information on the day of the appointment, we will be happy to file a patient's claim. Each patient must be familiar with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay. By law each patient's insurance company is required to pay each claim within 30 days of receipt. We file all insurance, so the insurance company will receive each claim within days of the treatment. Each patient is responsible for any balance on your account after 30 days, whether insurance has paid or not.
PLEASE UNDERSTAND that we file dental insurance as a courtesy to our patients. Our office does not have a contract with the insurance company, that contract is made with the patient/subscriber of the policy . Our office is not responsible for how the insurance company handles its claims or for what benefits is paid on a claim. Our office can only assist the patient in estimating the portion of the cost of treatment. At no time can our office guarantee what the insurance will or will not pay with each claim. In addition our office also can not be responsible for any errors in filing the insurance. Once again, our office file claims as a courtesy to you.
Pre-treatment Authorization: Some insurance companies recommend an estimate of the work to be done and the fees to be charged before determining their benefits to you. If so, our office will provide you with the pre-treatment fee estimate. In this case, it will be up to the patient to determine if he/she wishes to proceed with treatment before the insurance benefit is determined.
Dental Insurance Facts
Fact 1 – NO INSURANCE PAYS 100% OF ALL PROCEDURES
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 the subscriber or the patient employer has paid for coverage, or the type of contract the patient employer has set up with the insurance company.
Fact 2 – BENEFITS ARE NOT DETERMINED BY OUR OFFICE
Many have noticed that sometimes your dental insurer reimburses the patient 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 is not accurate.
Insurance companies set their own schedules, and 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 20%-30% profit.
Unfortunately, insurance companies imply that the treating dentist is “overcharging”, rather than say that the INSURANCE COMPANY 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.
Fact 3 – DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED
When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary (UCR) fee, we can figure out what benefits will be paid. First a deductible (paid by you), on average $50, is subtracted, leaving $100.00. The plan then pays 80% for this particular procedure. The insurance company will then pay 80% of $100.00, or $80.00. Out of a $150.00 fee they will pay an estimated $80.00 leaving a remaining portion of $70.00 (to be paid by the patient). Of course, if the UCR is less than $150.00 or your plan pays only at 50% then the insurance benefits will also be significantly less.
MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.
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 the subscriber or the patient employer has paid for coverage, or the type of contract the patient employer has set up with the insurance company.
Fact 2 – BENEFITS ARE NOT DETERMINED BY OUR OFFICE
Many have noticed that sometimes your dental insurer reimburses the patient 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 is not accurate.
Insurance companies set their own schedules, and 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 20%-30% profit.
Unfortunately, insurance companies imply that the treating dentist is “overcharging”, rather than say that the INSURANCE COMPANY 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.
Fact 3 – DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED
When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary (UCR) fee, we can figure out what benefits will be paid. First a deductible (paid by you), on average $50, is subtracted, leaving $100.00. The plan then pays 80% for this particular procedure. The insurance company will then pay 80% of $100.00, or $80.00. Out of a $150.00 fee they will pay an estimated $80.00 leaving a remaining portion of $70.00 (to be paid by the patient). Of course, if the UCR is less than $150.00 or your plan pays only at 50% then the insurance benefits will also be significantly less.
MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.