Having dental insurance can make obtaining quality orthodontic care more affordable.
At Western New York Dental Group, our treatment recommendations will always be based on the options for your specific condition. We will submit claims to your insurance company and advocate on your behalf, but ultimately expenses that your insurance company does not cover will be your responsibility.
Facts About Dental Insurance You Should Know
- Many dental plans are based on a contract between an employer and the insurance company. They agree on the amount that the plan pays and what procedures are covered. If you have a dental care need that is not covered by your plan, you are responsible for that cost. Because your orthodontic office is not part of that contract with the insurance company, any information we have about a dental plan’s benefits comes from the general information the insurance company has provided about that plan (through a web portal, speaking to an insurance representative, or by way of a limited, faxed benefit summary).
- A dental plan may not cover treatment for conditions that existed before you enrolled in that specific plan (such as treatment in progress). Even if your plan does not pay for certain procedures, you may still need that treatment to keep your mouth healthy. Your orthodontist will base your treatment plan on what you need, which won’t always align to what your insurance will pay for.
- Dental insurance rarely covers 100% of the services provided. Check your plan(s) for details regarding your orthodontic benefit.
- When we recommend a treatment plan, our team will be happy to provide you with an estimate of what your insurance will likely pay for the procedures. Although we cannot guarantee the amount of insurance payment, we will always submit claims to your insurance company. We will estimate your portion based on the general information that your insurance company provides for that plan. Just like with your medical coverage, you are ultimately responsible for any uncovered portion of the fee for treatment.
At Western New York Dental Group, our main goal is to partner with you to achieve a higher standard of oral health. We certainly understand that the insurance business is very complex and this complexity can lead to frustration. Our team wants to help you receive the maximum benefit that you are entitled to under your insurance plan by filing claims as a service to you. We would be happy to submit a pre-treatment estimate to your dental insurance provider.
To view a sample explanation of your bill statement with visuals click here. These On balances pending payment, statements are sent out on a monthly to keep you informed of your account.
If you have any questions please call your local Western New York Dental Group Office.
Your insurance policy is a contract between you and your insurance company. If our office is able to accept your insurance company’s assignment, it does not absolve the patient of responsibility for the charges in full for treatment rendered. Any estimate provided by our office is considered a guideline until the final insurance payment, if any, is received and the patient’s account has been reconciled. Our office can make no guarantee of the insurance payment as estimated. The agreed upon payment plan for the patient’s estimated portion must be kept current or the assignment will be cancelled and the full amount will become due and payable. Claims are submitted promptly after treatment is rendered. If a claim is not paid by the patient’s insurance company by the 61st day after treatment is rendered, the total outstanding account balance will be billed to the patient. Our administrative staff prides itself on helping our patients maximize their benefits. We are always available to answer any question you may have regarding our services. We strive to give each of our patients the optimum treatment plan and level of care available; therefore, we base your dental treatment on what is best for your health and do not let insurance coverage dictate your dental care. Any treatment which is not covered (in part or in full) by your insurance plan will be your financial responsibility. We will be glad to help you set up financial arrangements for any outstanding balance on your account. This courtesy discounts including senior citizen discounts will not be combined with any other discount or adjustment. If you have any questions about our financial options please contact us. View our locations or contact page to find the office that is most convenient for you. We will be happy to go over your options in more detail!