Understanding Dental Insurance

Our professional treatment is rendered to you, not the insurance company. You are ultimately responsible to us for the obligation of payment of treatment.

However, to serve and assist you in utilizing your dental insurance, this office accepts assignment of your benefits. It is your responsibility to provide us with accurate insurance information, and you are responsible for balances not covered by your policy on the day of service. For example, if your insurance company pays 80% on restorations (fillings), you are responsible for paying 20% of the amount of the restoration on the day you are treated.

Please understand that the amount to be paid by your particular policy is pre-determined and agreed to by your employer and the insurance company. Our office will be happy to contact your insurance company to determine the benefits your employer has provided for you. If you have any further questions about the amount the plan will pay or the treatments your plan will cover, you should refer these questions to your employer. At your request, this office will provide all pertinent information to your insurance company and we will do our best to help you derive the maximum benefits available. However, we are not responsible for determining what those benefits will be.

Some policies require a "pre-authorization" or "pre-determination" before treatment is begun. We will submit a treatment plan for review by your insurance company if this is a requirement.

Please remember that dental insurance is designed to assist people in obtaining dental care and rarely covers more than 1/3 to 1/2 of the total cost of service. There may be a deductible, a co-insurance factor, and a yearly maximum to be considered. Most insurance companies cover what they consider a "usual and customary fee". However, the insurance company sets these fees based upon what they want to pay: the fees are usually based on data that is several years old.

All these factors may combine to reduce the benefits you will ultimately receive. We will do our best to see that you receive your full benefits within the structure of your particular dental plan. However, ultimate responsibility for payment is yours and financial agreements must be defined before dental treatment can begin.