Insurance

We bill in line with a patient’s insurance.  We are contractually obligated to bill a patient portions and are not permitted to waive it as it would be constituted as insurance fraud.  Additionally, we are not permitted to change the date of service. Insurance varies greatly from carrier to carrier and unlike health insurance is much more limited.  For example, there may or may not be specialist coverage, there usually is an annual limit, and we do not know what may be in a pending state with the insurance company from another doctor. For this reason, we do require payment before treatment.

In most cases this is usually the co-payment only and is preauthorized by the insurance company.    It is not uncommon that HMO insurances have a long lead for authorization to see a specialist and typically require a referral from the general dentist.

We do address insurance discrepancies which typically follow as a result of final services rendered or available plan balance.  The insurance companies pay claims anywhere from 4 to 24 weeks.  A patient has more ability in getting an insurance company to process claims than does any dental office as the contract is between you and your insurance company.

FOLLOW UP: We do follow up with patients as we do want customer satisfaction and to help patients with any questions including what they are billed for.  At no point are we looking to leave patients in pain and we always do what is in the patient’s best interest to resolve comfort. We do place follow-up calls post procedure.

MULTI-VISIT: Treatment may take more than a single visit.   In certain cases, there is too much inflammation to perform a root canal and antibiotics are prescribed.  Typically, this is for a 7-day period, but can vary.  Sometimes this is an insurance requirement such as having a consultation and treatment apart for patient consideration and allows a patient an option to switch providers. This tends to be a case by case basis, but rest assured, we want to minimize these visits as they are inconvenient for the patient, and more costly to the office.  Regardless, we will do what is right.

EMERGENCIES: Emergency appointments are granted to patients and are generally focused on getting a patient out of pain – and yes there may be a wait as there are scheduled patients throughout the day.