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How
are Appointments Scheduled?
Do I Stay
with My Child During the Visit?
What About Finances?
Our
Office Policy Regarding Dental Insurance
How are Appointments Scheduled?
The office attempts to
schedule appointments at your convenience and when time is
available. Preschool children should be seen in the morning
because they are fresher and we can work more slowly with the
child for their comfort. School children with a lot of work to
be done should be seen in the morning for the same reason.
Dental appointments are an excused absence. Missing school can
be kept to a minimum when regular dental care is continued.
Since appointed times are
reserved exclusively for each patient we ask that you please
notify our office 24 hours in advance of your scheduled
appointment time if you are unable to keep your appointment.
Another patient who needs our care could be scheduled if we have
sufficient time to notify them. We realize that unexpected
things can happen, but we ask for your assistance in this
regard.
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Do I Stay with My Child During the Visit?
We invite you to stay with
your child during the initial examination. During future
appointments, we suggest you allow your child to accompany our
staff through the dental experience. We can usually establish a
closer rapport with your child when you are not present. Our
purpose is to gain your child's confidence and overcome
apprehension. However, if you choose, you may come with your
child to the treatment room. For the safety and privacy of all
patients, other children who are not being treated should remain
in the reception room with a supervising adult.
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What
About Finances?
Payment for professional
services is due at the time dental treatment is provided. Every
effort will be made to provide a treatment plan which fits your
timetable and budget, and gives your child the best possible
care. We accept cash, personal checks, debit cards and most
major credit cards.
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Our Office Policy Regarding Dental
Insurance
If we have received all of
your insurance information on the day of the appointment, we
will be happy to file your claim for you. You must be familiar
with your insurance benefits, as we will collect from you the
estimated amount insurance is not expected to pay. By law your
insurance company is required to pay each claim within 30 days
of receipt. We file all insurance electronically so your
insurance company will receive each claim within days of the
treatment. You are responsible for any balance on your account
after 30 days, whether insurance has paid or not. If you have
not paid your balance within 60 days a re-billing fee of 1.5%
will be added to your account each month until paid. We will be
glad to send a refund to you if your insurance pays us.
PLEASE UNDERSTAND that we file dental insurance as a courtesy to
our patients. We do not have a contract with your insurance
company, only you do. We are not responsible for how your
insurance company handles its claims or for what benefits they
pay on a claim. We can only assist you in estimating your
portion of the cost of treatment, we at no time guarantee what
your insurance will or will not do with each claim. We also can
not be responsible for any errors in filing your insurance, once
again we file claims as a courtesy to you.
Fact 1 - NO INSURANCE PAYS
100% OF ALL PROCEDURES
Dental insurance is meant to be an aid in receiving dental care.
Many patients think that their insurance pays 90%-100% of all
dental fees. This is not true! Most plans only pay between
50%-80% of the average total fee. Some pay more, some pay less.
The percentage paid is usually determined by how much you or
your employer has paid for coverage or the type of contract your
employer has set up with the insurance company.
Fact 2 - BENEFITS ARE NOT DETERMINED BY OUR OFFICE
You may have noticed that sometimes your dental insurer
reimburses you or the dentist at a lower rate than the dentist's
actual fee. Frequently, insurance companies state that the
reimbursement was reduced because your dentist's fee has
exceeded the usual, customary, or reasonable fee ("UCR") used by
the company.
A statement such as this gives the impression that any fee
greater than the amount paid by the insurance company is
unreasonable or well above what most dentists in the area charge
for a certain service. This can be very misleading and simply is
not accurate.
Insurance companies set their own schedules and each company
uses a different set of fees they consider allowable. These
allowable fees may vary widely because each company collects fee
information from claims it processes. The insurance company then
takes this data and arbitrarily chooses a level they call the
"allowable" UCR Fee. Frequently this data can be three to five
years old and these "allowable" fees are set by the insurance
company so they can make a net 20%-30% profit.
Unfortunately, insurance companies imply that your dentist is
"overcharging" rather than say that they are "underpaying" or
that their benefits are low. In general, the less expensive
insurance policy will use a lower usual, customary, or
reasonable (UCR) figure.
Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED
When estimating dental benefits, deductibles and percentages
must be considered. To illustrate, assume the fee for service is
$150.00. Assuming that the insurance company allows $150.00 as
its usual and customary (UCR) fee, we can figure out what
benefits will be paid. First a deductible (paid by you), on
average $50, is subtracted, leaving $100.00. The plan then pays
80% for this particular procedure. The insurance company will
then pay 80% of $100.00, or $80.00. Out of a $150.00 fee they
will pay an estimated $80.00 leaving a remaining portion of
$70.00 (to be paid by the patient). Of course, if the UCR is
less than $150.00 or your plan pays only at 50% then the
insurance benefits will also be significantly less.
MOST IMPORTANTLY, please
keep us informed of any insurance changes such as policy name,
insurance company address, or a change of employment.
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Pediatric Dentistry, Larry
Dormois D.D.S., Steve Fuson, D.D.S., John Acosta, D.D.S. ~ Pediatric Dentist
serving Memphis, Germantown, TN, & Southhaven, MS.
Copyright © 2007 ~ Larry Dormois, D.D.S., Steve Fuson, D.D.S., John
Acosta, D.D.S. ~ All Rights Reserved.
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