Financial/Insurance

Affordable children’s dentistry in North Scottsdale is here!!

Our office strives to provide superior dental care while also managing the cost of treatment. A very important part of managing costs is developing open, honest communication with our parents. In this way, we strive to develop strong relationships based on mutual trust, respect and understanding. Let's begin with some honest talk about your dental insurance policy.


Your treatment plan will include a breakdown of all applicable fees, and we will inform you of all costs before treatment is administered. Payment is expected at the time treatment is rendered, unless special arrangements have been made prior to your appointment. For the convenience of our patients, we accept Visa and MasterCard.

Insurance

It is important that you understand your policy because all insurance policies vary. We will review your insurance to determine the appropriate course of action and estimate the portion of your bill that you will pay. Please keep in mind that this is only an estimate. You may end up paying more or less than the initial estimate.

We are preferred providers for Delta Dental Premier Plans and will fully attempt to help you receive full insurance benefits.

Please bring in all of your insurance information when you come for your appointment. We will submit all insurance claims for you for your convenience. Your insurance company is required to pay each claim within 30 days. After 30 days, you are responsible for the balance on your account, whether it’s a reduced amount because of your insurance company’s payment or not. If you have not paid your bill by 60 days, we will begin to re-bill you, adding 1.5% interest each month. We will, however, send you a refund for the interest if your insurance company pays us late.

Other details that you should know about dental insurance:

  • No insurance company or policy pays 100% of a dental bill. Dental insurance is more of an assistance to help you pay for dental treatment. Most insurance plans pay between 50-80% of the average amount for a procedure. The portion covered by the policy is usually determined by how much your employer has paid for the coverage or by the contract your employer has with the insurance company.
  • We do not determine your benefits. Your insurance company will reimburse either our office or yourself, usually for only a portion of the actual fee. If this happens, your insurance company will tell you it is because our fee is higher than the UCR (usual, customary or reasonable) fee that has been predetermined by the company.

To set the UCR fee, insurance companies gather fee information from many claims that they process. They then choose an amount that they deem the UCR fee, which is the range of money that they will pay for a particular service. Unfortunately, sometimes this collected information is years old, and the company will set UCR fees lower than what they should be set in order to make a profit.

If this happens to you, please do not get the impression that we are overcharging you for the services we provide or that other dentists in our area charge less. Typically, less expensive insurance policies will have a lower UCR fee.

  • Don’t forget about deductibles and co-payments. When figuring your dental benefits, please do not forget to include deductibles and co-payments that are paid by you at the time services are rendered. It is also helpful to know your company’s UCR fees.

For example, let’s say you have a bill of $100, and you know that your insurance company has chosen $100 as its UCR fee. To figure out how much you will pay, first subtract the deductible amount, which is usually $50. This leaves your bill at $50. Let’s say your insurance company will pay 80% of the remaining $50, or $40. Therefore, out of a total bill of $100, the insurance policy will only cover $40, leaving you to pay the remaining $60 ($50 deductible and remaining $10 balance). This, of course, is only an example. Your company’s UCR fees may be higher or lower than $100, and your insurance policy may pay a larger or smaller percentage of your bill. These factors would change the total amount you would pay.

It is extremely important that you keep us informed of any changes to your insurance policy. We strive to do our best to accommodate you by filing your insurance claims, but we need your help to make this a smooth process. Please inform us of any changes with your policy name, insurance company’s address or if you change employers.