About Dental Insurance
If you have dental benefits, you are fortunate. Your dental benefits are based upon a contract made between your employer and an insurance company, and it can often help offset the cost of your dental treatment. Please be aware, however, that dental insurance does not work in the same way as most medical insurance, and very few patients will find that their insurance covers all of their treatment costs.
We currently accept all private care insurance plans (plans that do not require you to select a dentist from a list or require our office to accept a reduced fee for service). This means that we work with literally thousands of companies. Although we maintain computerized histories of payment by a given company, they do change. Therefore, it is impossible to give you a guaranteed quote at the time of service. We estimate your portion based on the most up-to-date information we have, but it is only an estimate.
If you would like to know your exact insurance benefit, we will be happy to file a “pre-treatment authorization” with your insurance company prior to treatment. If you would like to do this before committing to your treatment plan, filing for the “pre-treatment authorization” will delay beginning your treatment. This extra step, however, will give you the exact out-of-pocket figures you may require.
Many people receive notification from their insurance company that dental fees are “above usual and customary.” An insurance company determines their reimbursement level by surveying a geographic area, calculating the average fee, and then determining that 80% of the average fee is customary. Included in this survey are discounted dental clinic and managed care facilities, which have severely reduced dental fees that bring down the average. Any doctor in private practice will have fees that that insurance companies define as “higher than usual and customary.”
We bill your insurance as a courtesy. If insurance does not pay within 90 days, Waldron & Lee Dentistry will request payment in full for services from you. If/when your insurance ultimately pays, you will then collect the insurance funds that are due to you. This rarely happens, but it is important that you recognize that the insurance you have is a legal contract between YOU and your insurance company. Our office is not, and cannot be, a part of that legal contract. Ultimately, you are responsible for all charges incurred in our office.
If you have any questions regarding your dental benefits, you must contact your employer or insurance company directly. Dental benefit plans will never totally pay for completion of your dental care. It is only meant to defray some of the costs of dental care.
You may download a printable copy of our financial policy here:
Insurance Financial Policy