Insurance for Plainville, CT dental procedures

Although you may have dental insurance, payment is ultimately the Plainville and Farmington, CT patient’s responsibility. Reimbursement amounts vary from employer to employer.

Our trained staff can assist in determining the amount of your dental procedures coverage. Please read our office policy regarding dental insurance to learn more.

Our Office Policy Regarding Dental Insurance

If we receive all of your insurance information on the day of the appointment, we are happy to file your claim for you. However, you must be familiar with your insurance benefits; in most cases you can look up your benefits and print them out online. You are responsible for paying the estimated amount that insurance is not expected to pay. By law your insurance company is required to pay each claim within 30 days of receipt. We file all insurance electronically, so your insurance company receives each claim within days of dental procedures. You are responsible for any balance on your account after 30 days, whether insurance has paid or not. If you have not paid your balance within 60 days an interest charge of 1.5% per month or 18% per year will be applied to your bill. We will send a refund to you if your insurance pays us over the amount asked.

PLEASE UNDERSTAND we file dental insurance claims as a courtesy to our patients. We do not have contract with your insurance company, only you do. We are not responsible for how your insurance company handles its claims or for what benefits they pay on dental procedures claim. We can only assist you in estimating your portion of the cost of treatment. We at no time guarantee what your insurance will or will not do with each claim. We also cannot be responsible for any errors in filing your insurance. Once again, we file claims as a courtesy to you.

Fact 1 – NO INSURANCE PAYS 100% OF ALL PROCEDURES

Dental insurance is meant to be an aid in receiving dental care. Many patients think their insurance pays 90% – 100% of all dental fees. This is not true! Most plans only pay between 50%-80% of the average total fee. Some pay more, some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage, or the type of contract your employer has set up with the insurance company.

FACT 2 – OUR OFFICE DOES NOT DETERMINE BENEFITS

Many of our Plainville and Farmington patients have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist’s actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist’s fee has exceeded the usual, customary or reasonable fee (“UCR”) used by the company.

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable, or well above what most dentists in the Farmington and Plainville area charge for a certain service. This can be very misleading and simply is not accurate.

Insurance companies set their own schedules, and each company uses a different set of fees they consider allowable. These allowable fees may vary widely, because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a level they call the “allowable” UCR Fee. Frequently, this data can be three to five years old and these “allowable” fees are set by the insurance company so they can make a net of 20%-30% profit.

Unfortunately, insurance companies imply that your dentist is “overcharging”, rather than say they are “underpaying”, or that their benefits are low. In general, the less expensive insurance policy will use a lower usual, customary or reasonable (UCR) figure.

FACT 3 – DEDUCTIBLES

You are responsible for any deductibles or co-pays your insurance may have.

FACT 4 – FREQUENCIES & LIMITATIONS OF BENEFITS

The frequency of payment for some procedures may be limited by an insurance company. This can be encountered with procedures, such as cleanings, oral exam, x-rays and sealants. Please remember that we are a third party to your insurance company and will file most insurances as a courtesy to you. We cannot be responsible for keeping up with the ever changing policies of each individual insurance plan. We prefer to spend our time treating our Plainville and Farmington patients.

No insurance

Payment for professional services is due at the time dental procedures are provided. Every effort will be made to provide a treatment and payment option plan which gives you and your family the best care possible and considers your timetable and budget. We accept cash, personal check and most debit and major credit cards.

Your understanding and cooperation with this matter is greatly appreciated. You are helping to keep our overhead expenses, in the form of direct labor costs, down. In addition, you are helping keep fees as low as possible. If you have any questions, please feel free to ask our business office staff.

Dental financing

Everybody loves options. That’s why we offer the most options possible for patient financing. With Care Credit financing there are multiple financing programs available with low monthly payments. Approval is immediate. Ask about these programs today!