BENEFITS ARE NOT DETERMINED BY OUR OFFICE

You may have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist’s actual fee. 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 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 it considers allowable. These allowable fees may vary widely because each company collects fee information from the claims it processes.

Our fees are generally considered to fall within the acceptable range by most companies and, therefore, are covered up to the maximum allowance determined by each carrier. This applies only to companies that pay a percentage (such as 50% and 80%) of the usual, customary, and reasonable fees for the region ( U.C.R.) Thus, most companies consider our fees to be usual, customary, and reasonable. This statement does not apply to companies that reimburse based on an arbitrary “schedule of fees,” which bears no relationship to the current standard and cost of care in this area.

NOT ALL SERVICES ARE A COVERED BENEFIT IN ALL CONTRACTS

Some insurance companies arbitrarily select certain services they will not cover.

Please notify the office of any changes to your insurance at the time of appointment.