CONVENIENT PAYMENT OPTIONS
Our office is committed to offering flexible payment options to ensure that your dental care is affordable. For your convenience, we offer financing through Care Credit and Chase Health Advance both options do offer Interest Free and Extended Payment Plans. In addition we also accept MasterCard, Visa, Discover and American Express. We also offer a 5% discount for payment made at the onset of treatment. Our courteous staff will be happy to file your insurance claims for you. We are a preferred provider for Delta Dental, Blue Dental, Guardian, WEA, United Healthcare and Hawk-1 insurances. Referring your family and friends really pays! Contact us today for more information on our referral program.
UNDERSTANDING YOUR DENTAL INSURANCE
Why do my dentist’s fees sometime go over my insurance company’s maximum allowable UCR charges?
Here is the best way to answer that question. Did you know that one dentist can charge more for his or her services than another dentist and yet have his fees be all accepted within an insurance company’s fee allowances, while the lower priced dentist has fees rejected as over the maximum? Wow! Never heard of anything like that have you? Here is how that works. Look at the listed fees below and the UCR profile of the insurance company and you will see why this happens.
| Insurance company UCR | Doctor A | Doctor B | |
| Exam | $40.00 | 42.00 | 40.00 |
| x-rays | $36.00 | 34.00 | 36.00 |
| Cleaning | $52.00 | 46.00 | 51.00 |
| Total | $128.00 | 120.00 | 127.00 |
| Amount over insurance UCR | 2.00 | 0.00 | |
Now please note above. Doctor A only charged $120 for a checkup, x-rays and cleaning while doctor B charged $127.00, yet Doctor B had ALL of his fees covered while the less expensive doctor had $2.00 over the insurance company profile. The less expensive dentist will look like he or she charges too much, but that is not true.
You might ask why Doctor A just does not rearrange his fees to fit the profile for this insurance company better. Well, there are two very good reasons. First, it is illegal to rearrange fees to fit each insurance company profile. Second, every insurance company has a different fee profile for EVERY fee. There is no standard fee they all accept. We have over 1,600 different insurance company plans we must deal with. We are required to stick to one fee plan and use it for all insurance carriers. This means that there are, at times, insurance carriers in which EVERY dentist will have fees that fit within their profile and thus it will look as though the dentist’s fees are not over charged. But, this means also that EVERY dentist will have insurance companies in which he or she will have fees that are over the UCR for that company. Dentists are also not allowed to removed these charges from your bill unless the dentist has signed a contract with that insurance company saying they will discount fees over the UCR for that carrier.
I hope this has helped you understand your explanation of benefits report when you see a fee or two that are not fully covered or are over the UCR for your insurance plan. You are required to pay this fee and you now know that this is not unusual and that every dentist will have this happen to them with some insurance companies and not with other insurance companies.
