Insurance Information

Our insurance coordinators deal with many different insurance companies. Some companies offer many different dental and medical plans. These companies can change benefits, co-pays, and deductibles many times throughout the year. We do our best to provide you with accurate coverage estimates based on information available to us. At times, it is almost impossible to accurately estimate a patient's insurance co-payment. Many insurance companies will not give out fees until after the treatment is completed. Dealing with these companies can be difficult and time consuming. As a courtesy, we ask that you keep us informed of any change to your insurance. It is important that all information about you and your insurance is current.

Although we will gladly file a claim on your behalf, you may wish to submit the claim yourself. In general, insurers process claims filed directly by patients faster than those filed by the service providers (dental offices).

Further, most dental insurance policies are limited and often only pay for a portion of the procedure(s) that may need to be done.

Co-Payment

The majority of dental plans reimburse approximately 30-80 percent of treatment costs. With this in mind, we ask that 20 percent of the fee be paid at the time of treatment.

HMO Patients

If a patient comes to us with a problem that they expect to be covered by medical insurance (biopsies, tumors, TMJ, infections), they must have a referral from their primary care physician. A referral from a dentist is not adequate for medical insurance coverage. Obtaining a medical referral is the patient's responsibility. We cannot obtain the referral for you and the referral cannot be obtained retroactively. If you do not have a referral, we will be happy to see you on a cash basis, but your medical insurance company will not pay for your treatment.

Private & Group Insurance

As a courtesy to our patients with medical and/or dental benefit plans, we will submit necessary claim forms, receipts, and other information to your insurance company.

After your initial visit with Dr. Echols or Dr. Coppin you will have the chance to sit down with our financial coordinator and go over your insurance information as well as what we expect them to cover for your proposed treatment.  We will ask that you pay your estimated portion at the time of service.  Upon receipt of an insurance payment, any balance due will be billed to you. If you have deposited an excessive co-payment, it will be refunded to you.

What Every Patient Should Know About Dental Benefits

Here are some myths and facts about dental benefits

Myth: Dental insurance is similar to medical insurance.

Fact: Dental benefits can help pay for limited services such as preventive care and some single tooth or single quadrant dentistry within a calendar year, but dental benefits are so limited that they pay for a very small percentage of the fees for multiple tooth dentistry and complex treatment plans.  Some dental procedures are not covered at all by dental benefits.

Myth: I should ask the doctor to limit treatment to those items covered by my dental benefits

Fact:  We have an ethical obligation to diagnose and share our findings with you.  We base treatment recommendations on the needs of the patient, not the limitations of the benefits.  We respect your right to make decisions regarding your oral health, but we want you to be totally informed.

Myth:  If the doctor is not on my plan, I will not receive any benefits.

Fact:  It all depends on the plan.  Even if we do not work directly with a particular plan, we will submit the claim for you.  We ask that you pay us at the time of service, and it is possible-although not guaranteed-that you will receive some reimbursement from the insurance company.

Myth:  Insurance companies are a good source of information regarding dental fees.

Fact: Insurance companies base their “usual and customary” fees on averages.  The companies have no incentive to keep these statistics up to date (because it would cost them more money), and our practice is not average.  The fees you pay here reflect the quality of the care you receive.

Myth:  If there is a big difference between your fees and the amount the insurance company will pay, then your fees must be too high.

Fact:  Insurance company maximums have barely increased in the last thirty years! During that time, there have been many scientific advances in dentistry that we incorporate in our practice for your benefit.  We provide 21^st century dentistry, and we are certain that you would not like us to turn the clock back and only offer you what was available in the 1970's.

Myth: I have 100% coverage.

Fact:  There is no such thing as full coverage.  However, we will do everything possible to help you maximize your benefits.  We will also work with you and offer you several options to help you stretch out payments over time.