Insurance and Finance
FINANCE & INSURANCE “FAQ”1. DO YOU TAKE INSURANCE? 2. I HAVE INSURANCE. WILL I HAVE TO PAY FOR MY EXAM APPOINTMENT? 3. ARE YOUR DOCTORS IN MY INSURANCE NETWORK? 4. WHAT WILL MY TREATMENT COST?5. WILL YOUR OFFICE SUBMIT A PRE-DETERMINATION REQUEST TO MY INSURANCE CARRIER?6. DOES YOUR OFFICE ACCEPT MEDICAID PATIENTS?
ANSWERS TO FINANCE & INSURANCE FAQs
1. DO YOU TAKE INSURANCE?
We work with most major insurance carriers. When you come in, we will be happy to do a complimentary benefits check for you. It should be kept in mind that this is really a dental supplement with clear limits of payment and we encourage our patients to focus on their problem with disease first, looking at their dental supplement as a helping hand, not a source of complete payment. We ask that all new patients be prepared to pay for their initial appointment and x-rays, even if they have dental insurance. These initial fees can later be recovered from your insurance company if the expense is covered.
2. I HAVE INSURANCE. WILL I HAVE TO PAY FOR MY EXAM APPOINTMENT?
We are a fee for service practice and payment is due upon completion of your initial exam … however, we will be happy to electronically file your insurance claim for you. We will be happy to help with financial arrangements for later treatment as we assess your overall problem and what steps will be required to treat your disease state.
3. ARE YOUR DOCTORS IN MY INSURANCE NETWORK?
We work with most major Insurance Carriers, and our electronically-filed claims receive priority processing from them. When you come in for your first visit to our office, we will be happy to do a complimentary Benefits Check for you. Again, please remember to bring all medical and dental benefit information and cards to your Examination appointment.The term “Dental Insurance” is really a misnomer. A more accurate description of this type of compensation agreement would be “Dental Supplement” because, unlike Health Insurance plans, most Dental Insurance Carriers have an annual “cap” or limit on how much they will pay toward your dental needs—even though they are aware that dental disease has a very direct and negative impact on your overall health. For example, the American Heart Association and the American Diabetes Association have both issued statements concerning the negative impact of active infection on your organs and their function.
If that treatment has exhausted your annual allowed limit, then you will receive no supplemental help with further treatment. This harsh reality is why most of our patients appreciate the broad spectrum of payment arrangements made available by Dr. Bauer.
4. WHAT WILL MY TREATMENT COST?
Since all patients present with different stages of disease, and other mitigating factors—like how long they’ve had their particular condition—Dr. Bauer must complete your Examination before establishing your individualized Treatment Plan and determining the associated fee. The fee for various types of Prosthodontic and Dental Implants can vary considerably, dependent upon the type of problems you present with, their complexity, and the amount of surgical time needed to correct them.
5. WILL YOUR OFFICE SUBMIT A PREDETERMINATION OF BENEFITS FOR MY TREATMENT?
We will be happy to prepare a predetermination of benefits after a diagnosis and treatment plan have been established in your case. Patients must understand that this does not guarantee payment from the dental insurance company for the benefits that are to be predetermined. It is simply an estimate of benefits.