Insurance

Our office is a preferred and in-network provider for Delta Dental PPO and Premier Plans. We are not members of the Delta Tricare HMO plan. We will gladly work with other insurance plans as an out-of-network provider.  We are not currently members of Care Credit. 

Insured patients

Please be advised that if you choose to use your dental/medical insurance, as a courtesy to you we will submit your claim to the insurance company.  As part of this process, we will call your insurance company to obtain your benefits.  Please be aware that although every effort is made to obtain accurate information from your insurance company, they may pay the claim differently than was expected.  It is for this reason that we encourage you to contact your insurance company directly and obtain specific limits and benefits regarding your dental treatment.

Insurance Benefit

Benefits depend solely on what the purchaser (employer) wishes to offer.  Some plans cover as little as 30% or as much as 100% of covered services with most falling in the 50% to 80% range.  Most dental plans have a maximum amount in which they will pay each year, the estimated patient portion is based on amount quoted available by your insurance company the day of the consultation.  This may change if claims are pending for payment or benefit is utilized prior to scheduled surgery.   The insurance contract is directly between the patient and the insurance company.  Our office will not be notified by the insurance company regarding any changes to or termination of the insurance plan.  Please notify the office prior to the scheduled surgery date if a change has occurred to your insurance benefit so that we may re-verify the insurance benefit.

Co-payment and Insurance Usual and Customary Fee

Patients with insurance are requested to make an estimated co-payment towards their bill. (Exception: Blue Shield & Delta Tri-Care members must pay in full for all services.  We will bill the service(s) for you. Blue Shield & Delta Tri-Care pays the member only.)  Patients should be aware that some insurance companies only pay claim percentages based on their evaluation of what is “usual and customary” and not on our fee schedule. Therefore, although the estimated patient portion is collected at the time of service, if there is a patient portion after the insurance payment is received due to our fee not being accepted in full or benefits being paid to another provider prior to the scheduled surgery, a statement will be sent to you at that time for payment of the balance of the account.

Pre-Authorization

It is the patient’s responsibility to inform us if their insurance company requires pre-authorization of intended treatment. We will be glad to pre-authorize your treatment. Pre-authorization takes between 6-8 weeks.