Your treatment plan will include a breakdown of all applicable fees, and we will inform you of all costs before treatment is administered. Charges are payable at the time of treatment.
It is our mission to provide you with affordable, high-quality treatment, so we offer a variety of payment options to meet your needs. Our office accepts payments by cash, checks, and Visa, MasterCard, American Express and Discover credit cards.
If you have any questions about payment or if special arrangements are needed, please talk to our financial coordinator prior to receiving service. We will thoroughly explain your choices and work hard to accommodate your needs.
Additionally, we will submit all insurance claims for you. We will fully attempt to help you receive full insurance benefits; however, you are personally responsible for your account, and we encourage you to contact us if your policy has not paid within 30 days.
To our patients with insurance
Dental benefit insurance plans are made available to employees, or members, through companies, unions, and associations, and may vary considerably from one plan to the next.
The range of benefits depends solely on what the purchaser wishes to offer employees or members. Based on the premium dollar paid per person, plans may cover as little as 10% or as much as 80% of dental services. Some plans exclude certain types of services, e.g., dental implants; while other plans will cover a full range of dental services. The decision on how much to spend and what services will be covered rest solely with your employer and the insurance carrier.
As the number of patients covered by dental plans has increased, certain assumptions have become common, but are not necessarily true. Let me clarify:
- Our fees are based on the disease level and conditions present in the mouth, the treatment plan selected, and the time it takes to provide the necessary dental care. I do not believe it is in either of our best interests for us to compromise the treatment necessary to return you to health in order to accommodate an insurance program’s maximum benefit, which may be considerably less than optimal. However, we are more than happy to discuss a treatment plan’s advantages and disadvantages with you thereby involving you, rather than your insurance company, in the decision-making process about your health.
- The type of treatment you need and receive from us is based upon the severity of your disease and my professional judgment, and not on whether you are covered by a dental benefit plan.
- As a courtesy to you, our team will complete the dental portion of the claim form. To expedite processing, make sure that your part of the form is filled out completely and accurately.
- If you direct the insurance company to send your reimbursement directly to our office, you will receive credit for this amount. Upon receipt of an insurance check, our staff will reconcile the amount and bill, or refund, any difference.
- If your dental benefit plan requests a "predetermination" or "prior authorization," we will submit a treatment plan for comparison by your insurance carrier. Remember that their review only compares the treatment plan with what your premium payment purchased. The insurance carrier does not care if you are sick, or how soon you get well. Theirs is a FINANCIAL INTEREST, not a health-related one, so they cannot make this decision for you. In fact, the longer they take to review a claim, the longer they can refrain from paying on the premium your employer paid in. Since insurers make profit by leaving premiums invested in stock and money markets, ONLY the insurer benefits from a delay in the treatment decision. The financial obligation for dental treatment is between you and this office. The insurance company is responsible to you and not to this office.
- If you receive a communication from your insurance carrier suggesting that our fees are over and above the usual and customary rate for the services provided to you, please do not accept this as true. The insurance carrier’s reimbursement is determined solely by the amount of premium dollar paid by your employer. Lower premium payments result in lower reimbursements; higher premiums result in higher reimbursements.
- If, after our discussions, you believe that the dental benefits provided by your plan are inadequate, you may want to discuss this matter with your employer, union, or association, so that appropriate alternatives can be investigated.
We will help you as much as possible in completing claim forms, handling insurance queries, processing follow-ups, lost claims, etc. No question is too small for you to ask, whether it is about your treatment, benefit plan, or statement. Stop in, or call, any time you have a question. We are here to help you.
William M. Grover, DDS, PA
Your Grapevine, TX Periodontist