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Although we may not be a party to the contractual arrangement with your insurance company, we do want to help you receive the maximum reimbursement to which you are entitled. As a convenience to you we will help you process your insurance claims in order for you to receive this maximum benefit. We will also gladly provide dental x-rays and a written diagnostic report should your insurance company have any questions about the services provided.
At all times, you can be confident that we will always provide you with our best services without regard to the limitations imposed by your insurance coverage. To do otherwise would violate our contract with you — a contract we feel morally obliged to honor.
As a courtesy to you, we will fill out and submit the necessary forms for your insurance. In most cases you will be required to make a "copayment" to us. Since most insurance plans provide coverage of at best about 50-70% of the fee, in these cases we ask for 50% of the fee at the time of service. When we receive the settlement from your insurance company, we will adjust your account either to reflect an additional amount due, for which we will bill you, or an overpayment, which we will return to you. In some cases there is an adjusted fee schedule which you will be required to pay completely. In some cases you may initially be responsible for the entire fee to us, with reimbursement coming from your insurance company directly to you. Although we will try to assist you as much as possible with your dental insurance, we cannot guarantee any estimated coverage. It is important for you to understand that you are personally responsible for all the charges you incur in this office.
Dental insurance companies often assign a maximum fee they will allow for each procedure. This amount is usually much less than the typical fee for the region and can vary from one insurance carrier to another by over 50%. In fact, the amount a company allows for one dental office may be different than what it allows for another dental office in the same area! These fees are often not adjusted for inflation for years. In addition, most dental insurance companies have a very limited maximum annual benefit, and often this coverage has not been adjusted for decades. This amount may have been adequate to cover a variety of dental work thirty years ago but it is usually extremely inadequate today. The cost of dental care has not increased nearly as much as the cost of medical care over the last few decades, but it has naturally increased with inflation and the increased expenses involved with infection control regulations. Your dental insurance premiums may have been increased, but your benefits most likely have not.
We will try to inform you of the details of your plan. However, please do not expect us to know all the details of all the plans. There are hundreds of different dental insurance plans and they change frequently. It is impossible for us to know all the different benefits of all the plans all the time. Your dental insurance benefits are based upon a contract between you and your employer and the insurance company - not our office. The amounts and limitations of coverage are determined by the type of plan your employer has purchased. It is most effective for you to contact your employer or insurance company directly with concerns or complaints regarding those benefits.
We are here to provide dental services in a gentle and caring environment. Our goal is to save your tooth with a minimum stress to you. We will also try to make the financial aspect of your treatment as stress-free as possible. If you have further questions, please feel free to ask us.
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