1205 W McDermott Road, Allen, TX 75013 | 6050 Long Prairie Road, Suite 100, Flower Mound, TX 75028 | 200 East State Hwy 114, Roanoke, TX 76262
In an effort to help you understand your insurance policy and maximize your insurance benefits, we would like to share some facts about dental insurance with you.
FACT #1: Dental insurance is a contract between you, your employer and the insurance company. We are not a party to that contract.
FACT #2: Dental insurance is NOT meant to cover all fees. It is meant to be an aid to your investment in your dental health care. Many routine dental services are not covered by dental insurance. Even if you choose to go to a dentist that is “in-network,” you still must pay for many services not covered under the plan. “In-network” does not mean “free.” In fact, frequently you pay more out of pocket.
FACT #3: Many carriers claim that they reimburse the insured promptly “up to 80%” or “up to 100%” of the total fees.” In actuality, we have found that most plans cover about 40%-50% of average fees. Some plans pay more, some less. The less paid for the insurance by your employer, the less coverage you will receive.
FACT #4: Usual, Customary or Reasonable Fees, UCR, a term used by your insurance carrier, is an arbitrary amount which the insurance company chooses to pay for each procedure. It is not based on the average charge of practicing doctors in the area; it is merely the “allowable” amount they will reimburse so they can make a net 20%-30% profit. Our fees are within range of other dental offices in the area.
FACT #5: Insurance companies will not release the exact amount they will pay for a procedure until the treatment is completed and the claim is submitted. They will only state the percentage of their fee schedule that they will cover.
We will make every effort to assure you receive maximum benefits. We will file your insurance at no charge. In order to provide this service, we will need your updated insurance information before each appointment. Please do not hesitate to ask questions about our financial policy. We want you to be comfortable in dealing with these matters. If you have any questions regarding your insurance, we ask that you contact your employer regarding the specifics and details of your plan.
** For your protection, we collect 15% on all preventive services, even though your insurance policy may say that certain services are “covered at 100%.” We do not want our patients to be surprised and upset with unexpected balances after insurance pays the claims, and this policy has helped us achieve this goal. **