How does orthodontic insurance work?
There are many different agreements between insurance carriers and their subscribers, and each contract provides a different benefit. However, orthodontic insurance generally differs from regular dental insurance in that each insured individual usually has a lifetime maximum benefit for orthodontic services. This benefit is paid as a percentage of the orthodontic fee (initial fee, monthly payments, etc.) until the benefit maximum has been reached. Charges for lost or broken appliances may not be covered by insurance.
How does this office assist with insurance?
For your convenience, we will gladly assist you in submitting both predetermination and initial insurance claims pertaining to charges for care rendered in our office. However, please be aware that our primary financial relationship is with our patients or their families and not with their respective insurance companies. Final responsibility for collection of benefits from your insurance company rests with the insured party. Our professional services are rendered and charged directly to the patient or their family, and they are responsible for payment of all fees incurred.
What’s the next step?
Know what your benefits are before treatment starts. If you are not sure, contact your insurance company so you know exactly how much you can expect to be paid and when to expect payment. If desired, we will submit a pretreatment claim for determination of benefits for you. If you would like our office to submit claim forms for treatment, we ask that you provide us with the complete name, address and telephone number of your dental insurance carrier. When changes in employment or insurance coverage take place, please contact our office with updated information as soon as possible.
We cannot render services on the assumption that our charges will be paid by an insurance carrier. However, for your convenience, we will accept payments from your insurance company assigned to us by the insured. Such payments will be credited accordingly to your account. If your company requires verification of continuing treatment, we will be glad to complete the forms necessary on your behalf.