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InsuranceOur office participates with a number of insurance plans. Prior to your initial visit and for all subsequent visits please verify, in advance, that your converage is effective and that our clinic is still a provider. Also, a patient needs to know what their insurance has as a yearly maximum. A yearly maximum is the total amount of benefit each individual or family can receive in one calendar year. Knowing your policy is your responsibility. Our clinic, as a convenience to you will file most all claims but it is your responsibility, prior to consultation or treatment, to determine if your insurance gives you the benefit you expect. To this end and for your better understanding and benefit we encourage all treatment to be pre-authorized. Our clinic will assist you in pre-authorizing treatment. Unfortunately, your insurance company may take two to four weeks to reply. Upon receiving the pre-authorization our clinic will promptly call you to let you know what your insurance company says that they may pay toward the final treatment cost and what your estimated portion may be. This call from our clinic and the delivery of the treatment unfortunately does not guarantee payment from your insurance company. We will assist you in requesting payment a reasonable number of times but you, unfortunately, may be responsible for the total cost if your insurance carrier does not respond and/or does not ultimately respond in the manner or amount you thought they would. If you prefer to have treatment delivered immediately you will pay that day for the total cost of the treatment delivered that day and we will assist you in seeking reimbursement from your carrier. Again, your insurance carrier does not guarantee amount of payment under any circumstances. Fortunately, most insurance companies pay what they said they were going to pay and in a timely manner. Consequently, our clinic has found that most patients have few surprises in this area, especially if the patient is knowledgeable in the ways of their own insurance carrier and request pre-authorizations. When the pre-authorization is present at treatment the patient will pay only their estimated portion the day of treatment. We will assist you in billing your insurance company for the balance shortly after the treatment is complete. We do not offer payment plans. For your convenience we accept Visa, MasterCard and Discover. Here is an everyday example of the two choices a patient with insurance must make in deciding when their treatment is initiated. A patient presents to the clinic with a broken tooth and after given all the information about treatment choices, requests treatment in the form of a crown. Now, the patient chooses either immediate treatment or asks for a pre-authorization. Those are the two choices referred to previously. If the patient chooses immediate treatment, half of the total treatment cost is due immediately after the tooth is prepared and the remaining half is due two weeks later at the final appointment when the crown is cemented. We will then assist you in billing your insurance company to ultimately reimburse you. Be aware it may take your insurance company 4 to 6 weeks to reimburse you. If the patient requests pre-authorization, we will assist you in asking your insurance company what they may ultimately pay towards your crown. The patient then leaves and waits for our clinic to call with the results. Once we call you, we will tell you what your estimated portion is. With the pre-authorization in hand, we start the treatment at your first appointment and you will pay half of what your insurance says your estimated portion will finally be. Two weeks later, immediately after the cementation of the crown, you will pay the remaining half of what your insurance company says your estimated portion is to be. We will then assist you in billing your insurance company to pay the balance. Again, we strongly encourage pre-authorizations to help you make informed decisions about timing and extent of your treatment. All other treatment choices can and should be pre-authorized. |
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