Our office is committed to providing you with the best possible care. If you have dental insurance, we are anxious to help you receive your maximum allowable benefits. In order to achieve these goals, we need your assistance and your understanding of our payment policy. We participate with select dental and medical insurance plans. Please check with the receptionist to see if your plan is included among them.
Certain insurance plans require a written referral. It is the patient’s responsibility to present a properly dated referral at the time of the office visit. Co-payments for all insurances are due at the time services are rendered. The exceptions to having a referral of course is if you do not have a current dentist, or it is a sudden dental emergency.
We will gladly discuss our proposed treatment and answer any questions relating to your insurance. You must realize, however, that:
Your insurance is a contract between you, your employer and your insurance company. Not all services are covered benefits in all contracts. Some insurance companies arbitrarily select certain services they will not cover. You may have a yearly maximum which we are not privy to. This office quotes current fees that are within the usual and customary range of oral and maxillofacial surgery practices in our area. We are happy to file insurance claims for you. Our filing the claim on your behalf does not guarantee payment nor does a pre-determination of benefits represent a guarantee of payment. We ask that payment APPROXIMATINGyour estimated percentage of the fee be made at the time of surgery. Any charges not included in the payment received from your insurance company are your responsibility. If an open balance is not collected and goes into default, you will be responsible for all service fees and this may result in a small claims court action.
If a surgical procedure is required, we bill your insurance company for our surgeon’s fees only. Any services rendered outside of our office (i.e., pathology, labs, etc.) will be billed separately by each facility. We deal with many outside facilities; therefore, we cannot guarantee that any outside facility participates with your insurance or that all costs will be covered under your particular contract.
We must emphasize that as health care providers, our relationship is with YOU and not your insurance company. While the filing of insurance claims for surgery charges is a courtesy we extend to our patients, all charges are your responsibility from the date the services are rendered.
If you do not have insurance, payment in full is expected prior to service. We offer Care Credit to help make payments easier. Ask about this service if it may help.
If you have any questions about the above information or any uncertainty regarding insurance coverage, PLEASE don’t hesitate to ask us. We are here to HELP YOU.
Electronic Disclosure, Electronic Signature and Electronic Statements Agreement
Please read this Electronic Records Disclosure and Agreement carefully:
By checking the boxes on the website for patient forms, AND, by typing your name in the e-sign box here, you consent to the electronic delivery of the disclosures, information you provided, terms and conditions and any other documents to be included in your electronic and paper copy records. You also agree that we do not need to provide you with additional paper (non-electronic) copies of the disclosures, agreements, change notices, terms and conditions and any other documents, unless specifically requested. Once you consent to the disclosures and inclusion of your HIPAA protected information to be included in your records, you may request paper copies, which may result in a small copying fee.