Financial & Insurance
It is our mission to provide you with affordable, high-quality treatment that fits your budget! We offer a variety of payment options to meet your needs. Please ask our administrative team about how we can accomodate your needs.
Our financial team is available to assist our patients with their financial and insurance needs. We are participants in a numerous dental insurance providers. We also accept assignment of benefits toward your total dental fee and promise to work individually with to ensure you receive your maximum benefit.
We strive for excellence in customer service and to accomplish this goal, we take the time necessary to make sure we come to a mutual understanding of our dental services and fees. Below is a through explanation of our financial policy. We encourage you to ask any questions regarding your account. Our financial team is eager to assist you.
- If you have dental insurance, please bring your insurance card to your first visit. Also, please keep us informed of any changes in your dental coverage and provide us with the necessary updated information.
- We will be glad to file insurance claims for you once treatment has started.
- Any non-covered balance must be paid by the patient at the time of service. Based on the insurance information provided to us, we will estimate your portion in good faith. Please understand insurance policies vary and this is only an approximate estimate. Any additional unpaid balance becomes solely your responsibility.
- If your insurance company fails to pay your claim in a set amount of time, the remaining balance will become your responsibility.
If for any reason you have questions or are uncomfortable with anything listed above, or if we feel a mutual understanding of the financial policy above has not been met, we may ask that you pay for your services in full at the time of treatment and file your own insurance claims.
It is our goal to provide our patients with the highest standard of care and make your experience with us as pleasant as possible. By becoming familiar with our financial policy above, we trust we can come to a common understanding of dental insurance.
No Insurance pays 100% of all rendered services.
Dental insurance is only meant to serve as an aid in receiving dental care. While most believe their dental insurance covers 90-100% of all dental fees, in reality, normally only 50-80% of fees are covered by most dental insurances. Every insurance policy is different. It is determined by the type of contract your employer has set up with the insurance company.
Our office does not determine dental benefits.
Occasionally you may see that the amount reimbursed to you or the dentist may be lower than the dentist’s actual fee. Quite often, dental insurance companies claim it was reduced because the fee determined by the dentist was greater than the usual fee used by the insurance company. This often implies that the dental fee is far greater and unreasonable compared to what most dentists charge. This is inaccurate.
Each insurance company creates their own set of fees that they consider acceptable. The insurance company uses this information to create a level of UCR fees, or usual, customary or reasonable fees. Many times, this information is outdated or set to where the insurance company can make a 20-30% profit. So rather than admitting that their benefits are too low, insurance companies accuse your dentist of overcharging. Generally, less expensive policies use a lower reasonable figure.
We must consider deductibles and co-payments.
We must always take into consideration deductible and co-pays when estimating dental benefits. For example: if the dental fee is $150 and the UCR provided by the insurance company is $150, then we can easily determine what benefits will be paid. First, a deductible of $50 (on average) that will be paid by you will be deducted from the original fee, which leaves $100. The insurance plan states they cover 80% of this procedure so they will pay $80 of the remaining fee. So $20 of remaining charges plus the $50 deductible, leaves you (the patient) having to pay $70 of the $150 initial fee. Keep in mind, the lower the UCR determined by the insurance provider means the more you will pay.
Prior to your first visit at our office, we encourage you to contact your insurance provider to determine your coverage. Below are some common questions to ask:
- What is the frequency rate of exams, cleanings and fluoride treatments?
- Is there an age limit for fluoride treatments?
- Do you cover sealants? If so, is there an age limit?
- Does my policy cover orthodontics?
- Is there a waiting period?
We are currently in network with Delta Dental PPO, Aetna PPO, Metlife PPO, Delta Dental PPO/Premier, and BCBS SC State Plus and Federal.