Insurance Information

On the day of your pre-surgical consultation you will be given information regarding the charges for the procedures you will be having done in our office. It is important for you to know what your insurance policy covers. We recommend that you check with your insurance company if you have any questions regarding your benefits. Due to the growing number of insurance companies and plans available, it has become difficult for us to call and verify insurance coverage for every patient. We have found the phone policy of many insurance companies to be that they may only verify general benefit information to the doctors office. They usually cannot quote exact procedure fees, so we are not able to calculate the exact amount that your insurance will pay. We have found that many insurance companies may quote exact procedure fees to you ( the insured). You will want to be aware that any information received by phone from an insurance company is not a binding agreement for payment. It is best to have it sent to you in writing. Even Pre-authorization does not guarantee payment.

We are happy to file your insurance claim forms for you the day of your surgery to assist you in receiving the benefits your insurance company has contracted to provide you.

Key Questions to Ask Your Insurance When Verifying Your Benefits:

  • Yearly policy maximum
  • Benefits used so far in your calendar year
  • Calendar year dates
  • Usual and customary fees for the procedures you are having done
  • Is general anesthesia a covered benefit for the procedures you are having done?
  • Verify class code of procedures you are having done (extractions are usually Class ll)
  • If you have two insurances, does your plan have a non-duplication of benefits clause?
  • Age limit for dependent children
  • Student verification requirement

Pre-Determinations

If you or your insurance company requests, we will submit a pre-determination to your dental insurance to help you verify your coverage before surgery.Results from pre-determinations may take anywhere from 3 to 6 weeks depending on your insurance company.