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We will also file your insurance claims as a courtesy for you. It is important however, that you read your policy so that you understand the benefits you are entitled to, because the success of your dental insurance depends on your full understanding and cooperation in filing claims.
In addition to this courtesy, we may file a pre-authorization to get estimated co-payment from your insurance company. Please understand that this is only an estimate, and it is based upon the information available to us by your insurance company.
Most patients are unaware of their dental benefits. They feel that similar to medical insurance they will only have to pay a fixed office co pay during their dental visit. Dental benefits vary depending on the procedure being done. Dental procedures are generally categorized into preventative, basic and major.
Coverage with each of these categories varies depending on your insurance plan.
Most insurance companies allow a certain limit of dental expenses each year. Based on the type of treatment, benefits may vary. The insurance company pays a percentage of the expense depending on the type of service provided. This range of benefits depends solely on what your employer wishes to purchase or the personal policy you have purchased.
The financial obligation for dental treatment is between you and our office. The insurance company is responsible to you and not our office. We will be happy to assist you in any way that we can. Once your carrier had paid your claim, any difference will be due upon receipt of our statement. If for any reason we have not received your insurance carrier’s payment 60 days after the claim, the remaining balance will be due and payable by you.
“Our office is in network with the Delta Premier network, in network with Health Partner plans provided by employers and in network with Premier Dental or Sunlife Dental plans. Employers dictate plans’ out of network benefits. Some plans provide the same benefits to both in network or out of network providers. Others change your coverage when you choose an out of network provider. It is best to check with your employer or insurance company to determine your out of network benefits at our office.
Starting in January of 2022, we will no longer be in network providers for Delta PPO, State Medicaid Plans, and Delta Medicare Advantage Plans. Some Medicare plans still provide out of network benefits when coming to our practice. Your insurance advisors can help you choose a plan that will provide you with the best benefits at our practice.