You need to bring your insurance card, coverage booklet, and a completed and signed dental insurance claim form at your first visit, and at any time your insurance changes.
You need to be aware that:
We will always do our best to help you to maximize your benefits.
Although we file claims for you as a courtesy, your dental insurance policy is a contract between you, your employer and your insurance company. We are not a party to that contract (we are not a participating provider).
Your treatment plan is individually tailored and is not based on your dental insurance benefits or lack of benefits.
Not all services are a covered benefits in all contracts. Some insurance companies arbitrarily select certain services they will not cover. It is your responsibility to thoroughly understand the coverage and exceptions of your particular policy. Coverage issues can only be addressed by your employer or group plan administrator. We cannot act as a mediator with the carrier or your employer.
Our staff is trained to help you with questions you may have relating to how your claim was filed or regarding any additional information your carrier may need to process your claim. Please ask if you have any questions.
As a courtesy to all of our insured patients we will file your dental insurance claim forms for you. In special circumstances a particular insurance company's benefit check can be sent to our office directly. In such cases, you are responsible at the time of treatment for payment to us of any applicable deductible and for your co-insurance portion. Any payments made directly to you by your insurance company on unpaid balances should be forwarded immediately to our office so that your account may be credited accordingly. Monthly accruing interest at the rate of 1.5% in addition to a billing fee of $5.00 per monthly statement can be avoided if your personal financial responsibility is cleared within 30 days of your treatment, thereby eliminating the need for statements to be generated and mailed to you.
Your claim will be filed immediately and benefits are expected to be paid within 30 days. The filing of an insurance claim does not relieve you of timely payment on your account. If the claim is not cleared by your carrier in 45 days the unpaid portion will automatically become "self-pay" and a statement will be issued to you for the unpaid portion. You are responsible for any amounts your insurance company chooses not to pay for whatever reason. Any amounts expected to be paid by your insurance company but not cleared by them within 45 days become your responsibility and if not paid in a timely fashion, will begin to accumulate interest at the rate of 1.5% per month with the billing fee of $5.00 per monthly statement. Please feel free to contact your insurance company regarding unpaid benefits. We will gladly provide you with a letter which would include all pertinent information which you may sign and mail.