For patients presenting with dental insurance, you will be reimbursed for eligible services according to the fee guide that your insurance plan covers up to the percentage of reimbursement specified by that plan. With the introduction of recent federal privacy legislation, many insurance companies will not release the details of your policy directly to dental offices nor do they inform us of changes to your plan. It is the responsibility of policy holders to be familiar with these details and to communicate them to our office so that we may, where possible, help you maximize your reimbursement as well as advise you when procedures may not be covered so that you may make informed decisions about alternative treatment options.
- many plans have an annual deductible that is applied to your first claim of either the calendar year or the treatment year, as specified in your policy.
- many insurance plans have an annual maximum that varies from policy to policy. It is important to be aware of what your plan will allow you to claim annually.
- be aware of the limitations and exclusions outlined in your insurance policy. Your plan may have different levels of coverage for different procedures while some necessary treatment may not be covered at all.
- regardless of the level of insurance coverage you have, you are responsible for the entire fee charged by this office.
Your claims will be submitted electronically (where possible), directly to your insurance company and in most cases, you should receive your reimbursement within 3-7 business days. To expedite sending out your claims, we require:
1) the name of the insurance company
2) the group number and ID number of the policy holder
3) the name and birth date of the policy holder
4) the correct address (that corresponds to the address that the insurance company has on file)
5) NOTE: for college and university students, you must provide the name of the school you are attending and your parents must provide proof to the insurance company that you are enrolled in that institution (if this is a requirement of your policy)