Insurance Information

It is our goal to provide you with an all around positive experience and we do understand the financial portion is part of this.  To accomplish this we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures. We participate with most insurance plans.  Please keep in mind that the contract your employer negotiated with your insurance carrier determines your dental benefits.  Various plans cover endodontic procedures at different payment levels, so the amount you are responsible for can vary.  Based on our experience with your plan and/or calls we make to your carrier, we will require a deposit for the portion of the fee we estimate you will be responsible for, at the time of treatment.  After your insurance pays if there is a balance we will bill you.  If there is money due back to you, we send it out typically in one business day.  Please be aware the term “usual and customary” utilized by most insurance companies is rarely an accurate representation of the fees in the area.  For your convenience we accept Visa, MasterCard, Discover and American Express. If you have any questions regarding your account, please contact us at 603-624-9786. Many times, a simple telephone call will clear any misunderstandings.

Important:  please bring your insurance information with you to your first appointment so that we can expedite reimbursement and remember you are fully responsible for all fees charged by this office regardless of your insurance coverage.  Any remaining balance after your insurance has paid is your responsibility.   A rebilling charge and/or interest may be applied for balances which are not paid in full. 

dental insurance frequently asked questions:

1.  What is ”UCR” and how is it determined?

“UCR” is the term used by insuance companies to describe the amount they are willing to pay for a procedure.  There is no standard fee or accepted method for determining UCR and it will often vary from company to company.  At times the term is inappropriate, as the amount presented by your insurance company might bear no resemblance at all to the actual fees charged by specialists in your area.

2.  Why was my benefit less than I expected?

Most likely you have already used some or all of your annual benefits, your plan paid only a percentage of the fee (less than you expected), the treatment you needed was not covered by your plan, you had not met your deductible, or you were new to your plan and within the waiting period and were ineligible for coverage.  Please call your plan’s administrator, your dental insurance company or let us help, before you have your treatment.

3.  Why isn’t the recommended treatment covered by my insurance?

Some employers or insurance plans exclude coverage for some procedures as a way to reduce their costs.  Your plan may not include the particular treatment or procedure that is deemed the best option for dealing with your particular problem.

4.  What will my portion of the fee be?

Your payment portion will vary according to the UCR of your plan, your maximum allowable benefit and other factors.  We will do our best to try and inform you, but please keep in mind there are hundreds of plans and our determination is only an estimate.   We make use of an extensive data base of insurance benefits and have years of experience in this matter.  We make every effort to be as close as possible in our estimate, but sometimes we won’t know the exact number until your insurance payment has been received.

5.  How long does it take for my insurance company to pay the claim?

Most dental insurance companies process claims within 4 to 6 weeks, but not all are so efficient.  If you have any concerns, please don’t hesitate to call them, as they are typically more responsive to you than us.  If you want to file a complaint about a delayed payment, contact the insurance commissioner.

6.  Will my endodontist accept my insurance?

We participate with almost all insurances.  There are a couple, however, which we have had problems with over the years and no longer accept.  If you have one of these carriers, we apologize for the inconvenience.  In this instance, we will ask you to pay the fee and you will receive the benefit directly from your insurance carrier.  Often times, patients put the payment on a charge card and usually receive the insurance amount before their credit statement is due.

7.  What if I still have questions?

We have many, many years of experience dealing with dental insurances.  If you have any problems or questions, please ask our staff. They are well informed and up-to-date. They can be reached by phone at 603-624-9786.

 

 

 

Please call if you have any questions or concerns regarding your initial visit.