Pediatric Dentist Office Policies

How are appointments scheduled?
Do I stay with my child during the visit?
What about finances?
Our Office Policy Regarding Dental Insurance

 


How are appointments scheduled?

Our office attempts to schedule appointments at your convenience and when time is available. We recommend that preschool children are seen in the morning because they are more relaxed, we are able to work more slowly with them and make them more comfortable. School age children with extensive treatment needs are seen in the morning for the same reason. We provide excused absence forms when missing school and can keep missing school to a minimum when regular dental care is continued. Please recognize that we try to accommodate as many children in the off school hours as possible, but that we try to reserve these appointment for students in the higher grades.

Since appointed times are reserved exclusively for each patient we ask that you please notify our office at least 48 hours in advance if you are unable to keep your appointment. Another patient, who needs our care, could be scheduled if we have sufficient time to notify them. We realize that unexpected things can happen, but we ask for your assistance in this regard.

Do I stay with my child during the visit?

We invite you to stay with your child during their first visit and the initial examination. During future appointments, we suggest you allow your child to accompany our staff through the dental experience. We can usually establish a closer rapport with children when parents are not present. Our goal is to gain your child's confidence and overcome apprehension. However, if you would like, you are more than welcome to accompany your child to the treatment area. We recommend that a child be accompanied by no more than one adult at a time. For the safety and privacy of all patients, other children who are not being treated should remain in the reception room with a supervising adult.

What about finances?

Payment for professional services is due at the time dental treatment is provided. Every effort will be made to provide a treatment plan which fits your timetable and budget, and gives your child the best possible care. We accept cash, personal checks, debit cards and most major credit cards.

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Our Office Policy Regarding Dental Insurance

If we have received all of your insurance information on the day of the appointment, we will be happy to file your claim for you. You must be familiar with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay. Your insurance company is required to pay each claim within 30 days of receipt. We file all insurance electronically, so your insurance company will receive each claim within days of the treatment. You are responsible for any balance on your account after 30 days, whether insurance has paid or not. We will be glad to send you a refund if insurance overpays.

Please understand that we file insurance claims as a courtesy to our patients. We are not responsible for how your insurance company handles its claims or for what benefits they pay on a claim. We can only assist you in estimating your portion of the cost of treatment. We at no time guarantee how your insurance will process each claim. We also can not be responsible for any errors in filing your claim. Once again, we file claims as a courtesy and will be happy to assist you through this process.

Most importantly, please keep us informed of any insurance changes that may affect your claim such as policy name, insurance company address, or a change of employment.

Fact 1 - NO INSURANCE PAYS 100% OF ALL PROCEDURES
Dental insurance is meant to be an aid in receiving dental care. Many patients think that 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 - 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. 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 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 then chooses a level they call the "allowable UCR fee. Frequently, this data can be many years out of date as these allowable fees are set by the insurance company.

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

Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED
When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for a service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary fee, we can figure out what benefits will be paid. First a deductible (paid by you), on average $50, is subtracted, leaving $100.00. The plan then pays 80% for this particular service. The insurance company will then pay 80% of $100.00, or $80.00. Out of a $150.00 fee they will pay an estimated $80.00 leaving a remaining portion of $70.00 (to be paid by the patient). Of course, if the UCR is less than $150.00 or your plan pays only at 50% then the insurance benefits will also be significantly less.

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Pediatric Dentist & Orthodontics,, Worcester, MA 01605, Dr. Daniel Moheban - Children's Dentists of Worcester Pediatric Dentistry & Orthodontics

Serving patients in the surrounding cities and areas of Worcester, Massachusetts.

 

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