Frequently Asked Questions
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.
Dental insurance is a contract between you, your employer and the insurance company. We are not a party to that contract.
Dental insurance is NOT meant to cover all fees. It is meant to be an aid to your investment in your child’s dental healthcare. Many routine dental services are not covered by dental insurance.
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.
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 specialist 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 pediatric dental offices in the area.
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 company regarding the specifics and details of your plan.
Please contact us today to get your kid started on the path to better dental health. Time matters! For 25 years, at Giggles and Grins we’ve concentrated – every day — on “excellency… with a sense of urgency”.
If you have dental insurance, we are here to help you receive your maximum allowable benefits. In order to achieve these goals, we need your assistance and your understanding of our payment policy. Payment for dental services is due at the time the service is delivered unless otherwise arranged with our office. We accept cash, checks, MasterCard, Visa, Discover, American Express and Care Credit. Care Credit allows you to pay overtime with LITTLE or NO INTEREST. If we accept your insurance as payment, you are required to provide our office with complete insurance information when scheduling the appointment. Your insurance is a contract between you, your employer, and the insurance company. We are not party to that contract; however, we will do what is legally and ethically allowed to help you obtain your benefits. Many consumers believe that their insurance pays most or all of their dental expenses. In reality most plans pay only 50-80% of dental fees. How much your insurance reimburses for dental services is controlled by your employer, not our office. Our fees fall within the acceptable range of most insurance companies. Many insurance companies reimburse their policyholders based on a fee schedule which is not determined by the current standard of care. While the filing of insurance claims is a courtesy that we extend to our patients, all charges are your responsibility from the date services are rendered. Please contact us today to get your kid started on the path to better dental health. Time matters! For 25 years, at Giggles and Grins we’ve concentrated – every day — on “excellency… with a sense of urgency”.