Financial Information

About Insurance

We believe your dental health choices should be determined between you and your dentist. Our office is a non-contracted dental provider; however, our team is happy to file claims as a courtesy to our patients; you just need to provide us with your insurance details before your first visit. We are also dedicated to helping you maximize your benefits and get reimbursed for treatment; however, it is essentially the responsibility of the patient to understand the specifics of their insurance policy.

The main goal of insurance companies is to make money. If they perform more payouts, they become less profitable. Insurance carriers may try to claim patients did not send certain information they need so can try to avoid payments or delay them for 45 days. To help our patients, we will digitally record what information is sent to the insurance company and the date sent. Insurance companies have a 30-day window to pay any claims, as required by law. Our team will send claims electronically so they are received as quickly as possible. You may think most insurance plans pay 90-100% of average dental fees, but the reality is most insurance plans pay only 30-80%. In certain cases, dental insurance can reimburse policyholders at a lower rate than the dental office’s fees, but what was is reimbursed is ultimately up to the policy you have chosen, any contracts your employers has or how much coverage you have.

If your reimbursement is lower than the fees received at the dental office, it is because your insurance company believes the dentist’s fees have surpassed what they consider usual, customary or reasonable (USR). This could mislead or confuse patients, giving them the impression that their dentist is charging them more than other dentists in their area and not telling you about lower benefits or how they want to underpay fees. It is important to be aware that USR is based solely on what the insurance company wants to pay, their schedules and desire for profit, not on the fees in the area. Insurance companies often use outdated data to generate a 20-30% profit. Note: Lower cost insurance policies will use a lower UCR.