At the beginning of 2020 we made the decision not to renew our contracts with any insurance carriers. This decision was not made lightly and comes after much thought and consideration. We ultimately made this change to allow our dentists to make unbiased decisions that are based solely in the best interest of our patients.
Post COVID-19, we were forced to make many changes to our protocols and office procedures, which meant limiting the number of patients we can see in a day. To be able to best serve your child in the safest manner, we now block out more time per patient to satisfy our more rigorous infection-control protocols. Leaving the insurance networks was the only way to sustain these new measures and deliver the highest quality of care for your child.
Although we have stopped participating with any dental insurance provider networks, we still accept all PPO insurances. What this means is that your insurance company will still allow you to choose our office to provide care for your child, and afterward we will file a claim on your behalf to your insurance carrier. (For Delta Dental patients only, we ask that you pay for your entire visit up front, as Delta Dental will send reimbursement checks to the subscriber’s home address and no longer to the dental office. You should expect your reimbursement check from Delta 1-4 weeks from the date of the visit.)
What Does “Out-of-Network” Mean?
The term "out-of-network" is used by insurance companies when referring to medical/dental providers who are not under contract. It is important to know that your insurance company does not prohibit you from seeing an out-of-network provider, however, the insurance claims process and reimbursement rates may be different. For new patients or preventive visits, the changes will be minimal if any. The majority of your visit will now be covered through your insurance carrier’s out-of-network benefits, possibly leaving you with a small remaining balance, if anything at all. We will continue to submit your claims electronically on your behalf and verify your benefits prior to your visit. We are also happy to send in a pre-estimate to your insurance if you would like a more detailed financial breakdown prior to your visit, however please keep in mind that this is an estimate only and actual out of pocket costs may vary.
E-Claims Filing
To speed the process of filing insurance claims and help minimize the likelihood of clerical errors, we utilize an E-Claims filing system that submits claims electronically to your insurance company. The E-Claims system dramatically reduces the amount of time it takes for insurance companies to send your reimbursement. As such, it is very important to ensure that all of your personal information is entered correctly into our system. Even a small error can cause a delay in your claims processing. Our office staff is happy to provide you with a copy of your claim at the completion of your visit. Please contact us immediately if you discover any discrepancies.
Insurance policies and claims processing can often be confusing, so please feel free to contact our office if you have any questions. We are happy to work with you to help resolve any questions and alleviate any concerns.
We appreciate you trusting us with your child's dental needs and look forward to continuing to provide your care for many years to come.