REGARDING INSURANCE PLANS
NON-NETWORK PROVIDER – We are a non-network provider which means that we are not members of nor do we participate in any type of dental plans including PPO’s (Preferred Provider Organizations), DMO’s (Dental Maintenance Organizations), prepaid dental plans, discount plans, discount cards or any type of insurance plan or direct reimbursement plans. As such, we will collect a co-payment at the time of service in the minimum amount of thirty percent (30%) of the procedure fees. As a courtesy, we will be happy to send an insurance claim form to your insurance company along with any necessary backup information. If the claim is denied for any reason, the balance on your account is immediately due and payable. If the insurance company indicates they need additional information, upon receipt of the balance due on your account, we will provide them with any additional information requested on a one-time basis only. If an insurance company makes payment to our office and such payment creates a credit balance on your account, we will prepare a refund check to either you or the insurance company (whichever is deemed appropriate) within 48 hours of its receipt.
USUAL AND CUSTOMARY FEES
Insurance companies would like you to believe that usual and customary fees are the “average fees charged by dentists throughout your local area” for each respective procedure, when in fact nothing could be farther from the truth. Usual and customary fees vary from insurance plan to insurance plan and depend solely on the plan purchased by you or your employer. Even within the same insurance company, various types and levels of dental plans are offered, some of which are higher value plans with more procedures included in the plan and others of lower value with fewer procedures covered in the plan. The usual and customary fees represented in each plan are based on the value of the plan. This insures that a pre-determined level of profit will be made by the insurance company regardless of the plan or the procedure.
PRE-AUTHORIZATIONS AND PRE-DETERMINATIONS
Our office does not provide either pre-authorizations or pre-determinations for proposed treatment, either verbally or in writing. Pre-authorizations or pre-determinations are not required by insurance companies and are not a guarantee of payment by an insurance company. According to the insurance companies, they are intended to give you an idea of what might be covered for a particular procedure if (1) the plan is in effect at the time when service is rendered, (2) benefits have not previously been expended and (3) the procedure provided is a covered benefit. None of that will actually be determined until a formal claim has been submitted. Further, a claim cannot be submitted until treatment has been rendered. For that reason, the insurance company will never guarantee benefits based on a pre-authorization or pre-determination. If you want to obtain a pre-determination, you must do that on your own by phoning the insurance company. We will provide you with the proper dental billing codes and associated fees for your intended treatment. We will not speculate or advise you on how much an insurance company may or may not pay on a particular procedure even though we may contact your insurance company to confirm active coverage.
You are ultimately responsible for the payment of all outstanding charges on your account, regardless of your insurance coverage. Procedure codes are billed exactly as they relate to the treatment completed. We will not bill your insurance company using a procedure code that differs from the treatment performed, because such action constitutes fraud. We will assist you in obtaining payment from your insurance company as noted above, but dealing with your insurance company beyond our providing backup information for your claim is your sole responsibility.
ACCOUNT STATEMENTS AND DELINQUENT ACCOUNTS
A statement of your account will be mailed to you each month if an outstanding balance exists. You will receive a statement even though a claim has been submitted to your insurance company and payment from the insurance company has not yet been received.
On all overdue accounts, collection activity will proceed as follows:
No. Days Overdue Action
45 - Balance due in full.
60 - Second reminder letter by mail
90 - Account is sent to a collection agency or small claims court
In all situations, the count of days overdue will begin on the date when the claim is submitted, usually on the day when treatment is started.
If an account is referred to small claims court and a judgment is rendered in our favor, in addition to your overdue balance, you will also be responsible for the payment of all court costs and attorney fees associated with obtaining such a judgment. A minimum charge of $75.00 will be added to your account if it is referred to small claims court. If, due to unknown circumstances, you are unable to pay your account in a timely manner prior to collection activity commencing, please contact our office to make arrangements for payment. You can consider making arrangements with your financial institution to arrange a payment plan or make application for Care Credit through our office. If you have any questions regarding your account at any time, please feel free to contact the receptionist during normal office hours.
NSF CHECKS AND CHECKS DRAWN ON CLOSED BANK ACCOUNTS
If a check is returned unpaid to our office from your bank due to non-sufficient funds, we will apply a $15.00 NSF charge to your account and contact you either by telephone, text or email and advise you as such. At your request, we will resubmit the check one time only and if it is returned unpaid a second time, an additional $25.00 NSF charge will be added to your account. At your option, you can personally pick up the NSF check from our receptionist upon payment of the balance due. If you instruct us not to resubmit the check and you fail to clear the balance due within 5 working days of when the check was first returned, an additional $25.00 NSF charge will be added to your account at that time.
If a check is returned unpaid to our office from your bank due to a closed account, a $25.00 NSF charge will automatically be added to your account. We will contact you either by telephone, text or email and advise you as to the returned check,
We will schedule your appointment as promptly as possible.
When you call to schedule your appointment, please advise us of your signs and symptoms, as well as any information on your referral slip or from your referring Dentist. Treatment is only recommended when examination and consultation points to a clear diagnosis and indication to treat. Please let us know if you need any assistance to make your experience more comfortable.
More complicated cases including previous Endodontic Treatment or Retreatment, Surgery, Resorption and some Fractures typically require a dedicated consultation appointment in order to allow time for CBCT scans, and careful review of treatment options.
If you are in significant pain or in need of urgent care, we will make every effort to accommodate you ASAP. We are on-call to manage urgent circumstances after hours for patients of record. If you have an after hours emergency, you can reach us by calling our office and following the directions on our voice message.
STAYING ON SCHEDULE
We are conscious of staying on schedule and try our best to minimize delays. Your time is important and we try our best to stay on schedule and see you at the time of your appointment. However, given the technical nature of endodontics and the attention to detail that we give to every case, circumstances may arise that could prolong treatment time. Emergency cases can also arise and cause delays. We typically are able to help emergency patients with minimal disruption to the schedule, but this is not always possible. We sincerely appreciate your understanding and patience!
The quality of your care is very important to us. Once an appointment has been made, this time has been reserved for you with the appropriate amount of time and staff for your treatment. We kindly request notice of any appointment changes or cancellations at least 24 hours in advance so we can use the time to assist another patient.
Monday - Thursday: 8 am - 5 pm.
Your initial appointment will consist of a consultation where we will perform a few simple tests, radiographs, and a CT Scan to confirm recommended treatment. We will thoroughly explain your diagnosis and treatment options, if needed. Treatment can generally be done on the same day; however, a complex medical history or treatment plan may require an evaluation and a second appointment to provide treatment on another day.
Once your appointment is made, your username and password is emailed to you, which allows you to login and complete your registration.
Please have all online registration formsfilled out in advance (ie Health History, Pain History, Office forms, etc) in the comfort of your home. This will save you time at the office. Please contact us at 907-279-3636 if you have any questions.
If you do not have computer access, we will be happy to assist you at the office. Please arrive 20 minutes prior to your scheduled appointment to complete these forms.
If you have dental insurance, please provide this information to our staff before your first visit. This will save time and allow us to process any claims. You may also call your insurance company to find out about your dental coverage for the initial consultation and root canal treatments.
If you plan on using Care Credit, please alert us and bring your card or 16 digit account #.
We will need to take radiographs as part of the consultation protocol. It is important that we take radiographs of the tooth or teeth in question for our records. This allows us to provide you with a thorough evaluation and consultation of your chief dental concerns.
Please assist us by providing the following information at the time of your appointment:
- Your referral slip
- A list of medications you are presently taking if you did not complete the Health History online prior to coming in.
- If you have dental insurance, please bring your insurance card and information.
- Radiographs (X-Rays)
A parent or guardian must accompany all patients under the age of 18 at the consultation visit.
Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are on any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.) or require medication prior to dental procedure (i.e antibiotics, sedatives)