We accept most insurances. Since employers are changing insurance coverage due to economic distress, please call us to see which insurance plans we are a participating provider for. If we aren’t a participating provider for your insurance company, just call us with your insurance information and we can contact your insurance company to see about becoming a member. Our goal is to best serve our patients with their insurance benefits in these changing economic times. We do not accept any state sponsored dental insurance, such as OHP and Capital.
Dental insurance is an aid to financially help the patient. It is not necessarily meant to cover all dental expenses. We go to great lengths to acquire your insurance benefits information and communicate to you what your insurance company has communicated to us. Since your insurance company does not tell us all of their limitations we are also limited in what we tell you.
You, through your employer, have a direct relationship with your insurance company. You also have a direct relationship with your doctor. Your doctor does not have a relationship with your employer or your insurance company. Therefore, financial arrangements are made with you and not your insurance company. The insurance company is responsible to the patient. Please read your policy or call your insurance company so you are fully aware of any limitations of the benefits provided. We cannot be responsible for deficiencies or problems in individual plans.
Some insurance companies state that certain dental fees are above the “usual and customary” rather than admit the insurance benefits are low. We also know that some companies do not upgrade fee schedules regularly, even with the cost of living index. It is logical then, that there may be an attempt to shift the blame. Our fees have been approved by the Delta Dental Service (one of the nation’s largest dental insurance carriers) to be usual, customary and reasonable (UCR) for our geographical area. Any insurance company that states otherwise is using inaccurate or out of state UCR data in order to make their limited benefits look like our office is the problem. In order to cut costs, insurance companies are putting “caps” or maximums on their fees. They will quote us a percentage but end up paying us less than indicated. Therefore, it is very difficult to give you a precise estimate for your insurance payment. You are totally responsible for your entire dental bill.
If your insurance company does not pay what you expected or would like, please remember that your insurance company should not decide your dental health. You Should! In the event you do not receive the benefits that you believe you are entitled from the insurance carrier, contact your employer’s benefit department, your insurance representative, your union agent or the State Attorney General’s office.
With the high consumption of sodas by kids, many are getting cavities around existing fillings. Due to a high incident of this in recent years, many insurance companies have added a new clause, whereas they won't pay for recurring caries within 2 yrs of initial placement.
We send most of our insurance claims electronically. If you wish for us to mail them instead, please let us know.