Our office currently participates with a select group of medical and dental insurers. If you are insured by one of these companies, you will only be liable for your unmet annual deductible, co-payments, and uncovered procedures or, depending on the policy, a “preferred fee”. These payments are also due at the time services are provided. Our office staff will be glad to answer any questions regarding your specific coverage as it relates to our office payment procedures.
We will gladly discuss your proposed treatment and answer any questions relating to your insurance. At your request, we can obtain a pre-determination of benefits from your insurance carrier. You must realize, however, that:
- Your insurance is a contract between you, your employer, and the insurance company. We are not a party to that contract.
- Our fees are generally considered to fall within the acceptable range by most companies, and therefore, are covered up to the maximum allowance determined by each carrier. This applies only to companies who pay a percentage of “UCR” (ie, 50%, 80%). “UCR” is defined as the usual, customary and reasonable fee for a particular region. This statement does not apply to companies who reimburse based on an arbitrary “schedule” of fees which bears no relationship to the current standard and cost of care in this area.
- Not all services are a covered benefit in all contracts. Some insurance companies exclude various services. Some may be reimbursed on your major medical policy.
- In order for our staff to best advise you on your insurance coverage and your financial responsibility and to allow for efficient claims submissions, it is imperative that you bring your insurance identification cards with you at the time of your first appointment.
- Please be advised that some managed care medical and dental plans require referrals from a primary care physician. Consult your plan benefits booklet to determine if this applies or check with our staff when scheduling your appointment.
We must emphasize that as health care providers our relationship is with you, not your insurance company. While aid in filing insurance claims is a courtesy that we extend to our patients, all charges are your responsibility from the date the services are rendered. We realize that in some cases temporary financial problems may affect timely payment of your account. If such problems do arise, we encourage you to contact us promptly for assistance in the management of your account.
If you have any questions about the above information or any uncertainty regarding insurance coverage, PLEASE don’t hesitate to discuss it with us. We are here to help you.