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 On the day of your consultation you were given information regarding the charges for the procedures you will be having done in our office. It is important for you to know what your insurance policy covers. We recommend that you check with your insurance company if you have any questions regarding your benefits. Due to the growing number of insurance companies and plans available, it has become difficult for us to call and verify insurance coverage for every patient. We have found the phone policy of many insurance companies to be that they may only verify general benefit information to the doctor's office. They usually cannot quote exact procedure fees, so we are not able to calculate the exact amount that your insurance will pay. We have found that many insurance companies may quote exact procedure fees to you ( the insured). You will want to be aware that any information received by phone from an insurance company is not a binding agreement for payment.
We are happy to file your insurance claim forms for you the day of your surgery to assist you in receiving the benefits your insurance company has contracted to provide you.
Key Questions to Ask Your Insurance When Verifying Your Benefits:
- Yearly policy maximum
- Benefits used so far in your benefit year
- Benefit year dates
- Usual and customary fees for the procedures you are having done
- Is general anesthesia a covered benefit for the procedures you are having done?
- Percent of coverage you are currently at.
- Verify class code of procedures you are having done (extractions are usually Class ll)
- If you have two insurances, does your plan have a non-duplication of benefits clause?
- Age limit for dependent children
- Student verification requirement
Pre-Determinations
If you or your insurance company requests, we will submit a pre-determination to your dental insurance to help you verify your coverage before surgery. To request a pre-determination or if you have questions regarding pre-determinations please call the office most conveniently located for you. We will be submitting and following up on your pre-determination for you. We will call you when we have received the written response from your insurance. You will also receive a copy of your pre-determined benefits from your insurance company. Results from pre-determinations may take anywhere from 3 to 6 weeks depending on your insurance company.
We are Participating Dental Care Providers With Most Insurance Companies.
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