At Aspen Dental House, we believe that you deserve the best care. That’s why we always present you with the best dental solution possible to treat your personal situation. We accept most insurance plans (all PPO's) for payment, however, we have chosen not to be contracted with any insurance company. We have made this election to allow our staff and doctor to spend more personalized time with our patients. If you need help in locating a clinic that is contracted with the insurance companies, we will be more than happy to assist you.
Insurance companies keep reeimbursement amounts confidential, therefore, every estimate we provide our patients' regarding insurance reimbursement is the best estimate based on the information given to us by the insurance companies.
Our typical experiance with PPO insurance complanies is that they will reimburse 80 -100% of our initial exam fee, x-rays and cleaning. Please do not hesistate to contact our office should you need more infromation regarding your insurance benefits (214.979.3278).
FYI FOR PATIENTS WHO HAVE INSURANCE
If you are fortunate to carry dental insurance here are some important things you should know………
Your dental benefits are based upon a contract made between your employer and an insurance company. If you have any questions regarding your dental benefits please contact your employer or insurance company directly. Dental benefit plans will never pay for completion of your dental care. It is only meant to assist you.
We currently accept all private care insurance plans (plans that do not require you to receive care from a selected list of dentists or dentists "in network"). In our efforts to provide our patients with increased doctor-patient time and the very best materials, we have elected to be a private out-of-network provider. This means that we work with literally thousands of companies including most PPO plans. Although we can maintain computerized histories of payment by a given company, they do change; therefore it is impossible to give you a guaranteed quote at the time of service. We estimate your portion based on the most up-to-date information we have, but it is ONLY AN ESTIMATE. If you would like to know your exact insurance benefit, we will be happy to file a “pre-treatment authorization” with your insurance company prior to treatment. This does delay treatment but will give you the exact out of pocket figures you may require.
Many people receive notification from their insurance company that dental fees are “above usual and customary.” An insurance company determines their reimbursement level by surveying a geographical area, calculating the average fee, and then determines that 80% of the average fee is customary. Included in this survey are discounted dental clinics and managed care facilities, which have severely reduced dental fees that bring down the average. Any doctor in private practice will have fees that insurance companies define as “higher than usual and customary.”
If we take assignment on your insurance, we feel that 30 days is a reasonable length of time for us to wait for payment from your insurance company. If insurance does not pay within 30 days, Aspen Dental House reserves the right to request payment in full for services from you and let you collect the insurance funds that are due to you. This is rare but it is important that you recognize that the insurance you have is a legal contract between YOU and your insurance company. Our office is not, and cannot be a part of that legal contract. Ultimately, you are responsible for all charges incurred in our office.
Aspen Dental House does require payment in full for your portion at the time of service. We accept MasterCard, Visa, American Express, cash, and checks (for existing patients with established payment history). If you are in need of an extended finance option, we also work with Care Credit, who offers a six month “same as cash” or longer terms with an interest bearing revolving charge designed to meet your treatment plan needs on approved credit. Just ask one of the patient services staff for an application.
Please do not hesitate to ask us any questions about our office policies. We want you to be comfortable in dealing with these matters, and we urge you to consult us if you have any questions regarding our services and/or fees. We will fill out and file insurance forms at no charge. We will do all that we can to assure you of maximum benefits.
Facts You Should Know About Dental Insurance
FACT #1: Your dental insurance is based upon a contract made between your employer and insurance company. Should questions arise regarding your dental insurance benefits, it is best for you to contact your employer or insurance company directly.
FACT #2: Dental insurance benefits differ greatly from general health insurance benefits. In 1971, your dental insurance benefits were approximately $1,000 per year. Some 3 decades later, you will note that your benefits are still $1,000 per year. Figuring a 6% rate of inflation per year, you should be receiving approximately $5,000 per year in dental benefits. Your premiums have been increased, but your benefits have not. Therefore, dental insurance is never a pay-all; it is only an aid.
FACT #3: You may receive notification from your insurance company stating that the dental fees are “higher than usual and customary”. An insurance company surveys a geographic area, calculates an average fee, takes about 80% of that fee and considers it customary. Included in this survey are discount dental clinics and managed care facilities which bring down the average. The fee for service doctor in private practice will have a fee that insurance companies define as “higher than usual and customary”.
FACT #4: Many plans tell their participants that they will be covered “up to 80% or up to 100%”, but do not clearly specify plan fee schedule allowance, annual maximum or limitations. It is more realistic to expect dental insurance to cover 35% to 65% of major services. Remember, the amount a plan pays is determined by how much the employer paid for the plan. You get back only what your employer put in, less the profits of the insurance company.
FACT #5: Many routine dental services are NOT covered by insurance companies.