Insurance plans vary considerably. We suggest that you determine which of these limitations apply to your particular contract. Some health insurance contracts contain a “table of allowances” or a “schedule of benefits.” These tables are not fee schedules, although they may be described as such in your contract. They are lists of the amounts toward the surgeon’s actual fees which your insurance company will pay under the terms of the contract. In some cases, these amounts may be less than the actual fees. Should you wish to determine the benefits to which you are entitled under the provisions of your contract, we recommend that you contact your employer, union or insurance agent to obtain precise information about the extent of your coverage.

Dental / Medical Insurance

Our knowledgeable insurance staff will gladly answer your insurance questions and file medical and dental claims. Because your insurance is a contract between employer and your dental or medical insurance company, benefits received are based on the terms and limitations of the contract negotiated between them. We will file a claim form with eligible insurance carriers in order to achieve reimbursement for you, but please remember that you are responsible for all co-pays, deductibles and non-covered procedures. We encourage you to read and understand your insurance policy and know the coverage or limitations your personal medical or dental insurance policies may have.

We know questions arise on insurance matters. We encourage you to discuss any questions that you may have with our insurance staff.

Some Managed Care benefit plans require pre-authorization and specialist referral forms from your primary physician. We will abide by the provisions of the contract in filing your insurance and taking the necessary write-offs; however, it is your responsibility to see that a referral is obtained on every visit and co-pays, patient out-of-pocket and deductibles are paid on the day of service. If we do not have a referral you will need to reschedule or sign a waiver stating that you understand a referral was not obtained and you will be asked to pay the full charges on the date of service. If further treatment is necessary, it will be your responsibility to obtain the full referral before we can proceed with filing the insurance.

We will bill Medicare for you for covered procedures. All co-payments and deductibles are due and payable at the time of service is provided. Medicare does not cover teeth extractions or surgery on the supporting structures of teeth except for extraction of teeth prior to radiation therapy for cancer patients.

Workers Compensation

If your injury is work-related, we require the necessary insurance billing information and employer authorization form prior to your office visit or treatment.

Personal Injury Cases

This office does not accept liens or bill for auto-accident or other liability or lawsuit-related cases. The patient is responsible for the service provided at the time of service.

Avoiding Misunderstandings

Denial OF Benefits

We hope that the information provided here will be helpful to you. Realizing the importance of health insurance to your well-being, we urge you to become familiar with your health insurance contract and utilize its benefits. In the event that you do not receive the benefits to which you believe you are entitled from your insurance carrier, we suggest that you contact your carrier and your employee benefits representative to request the appropriate professional review. If we can be of assistance to you in these endeavors, we will make every effort to do so.