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Our office does accept some insurances.
Please call for details, 212-986-2039
How are Appointments
Scheduled?
Do
I Stay with My Child During the Visit?
What About Finances?
Our Office Policy Regarding Dental Insurance
How are Appointments
Scheduled?
The office attempts to schedule appointments at your convenience and
when time is available. Preschool children should be seen in the
morning because they are fresher and we can work more slowly with
them for their comfort. School children with a lot of work to be
done should be seen in the morning for the same reason. Dental
appointments are an excused absence. Missing school can be kept to a
minimum when regular dental care is continued.
Since appointed times are reserved exclusively for each patient we
ask that you please notify our office 24 hours in advance of your
scheduled appointment time if you are unable to keep your
appointment. Another patient, who needs our care, could be scheduled
if we have sufficient time to notify them. We realize that
unexpected things can happen, but we ask for your assistance in this
regard.
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Do I Stay with My
Child During the Visit?
We invite you to stay
with your child during the initial examination. During future
appointments, we suggest you allow your child to accompany our staff
through the dental experience. We can usually establish a closer
rapport with your child when you are not present. Our purpose is to
gain your child's confidence and overcome apprehension. However, if
you choose, you may come with your child to the treatment room. For
the safety and privacy of all patients, other children who are not
being treated should remain in the reception room with a supervising
adult.
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What About Finances?
Payment for professional services is due at the time dental
treatment is provided. Every effort will be made to provide a
treatment plan which fits your timetable and budget, and gives your
child the best possible care. We accept cash, personal checks, debit
cards and most major credit cards.
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Our Office
Policy Regarding Dental Insurance
If we have received all of your insurance information on the day of
the appointment, we will be happy to file your claim for you. You
must be familiar with your insurance benefits, as we will collect
from you the estimated amount insurance is not expected to pay. By
law your insurance company is required to pay each claim within 30
days of receipt. We file all insurance electronically, so your
insurance company will receive each claim within days of the
treatment. You are responsible for any balance on your account after
30 days, whether insurance has paid or not. If you have not paid
your balance within 60 days a re-billing fee of 1.5% will be added
to your account each month until paid. We will be glad to send a
refund to you if your insurance pays us.
PLEASE UNDERSTAND that we file dental insurance as a courtesy to our
patients. We do not have a contract with your insurance company,
only you do. We are not responsible for how your insurance company
handles its claims or for what benefits they pay on a claim. We can
only assist you in estimating your portion of the cost of treatment.
We at no time guarantee what your insurance will or will not do with
each claim. We also can not be responsible for any errors in filing
your insurance. Once again, we file claims as a courtesy to you.
Fact 1 - NO INSURANCE PAYS 100% OF ALL PROCEDURES
Dental insurance is meant to be an aid in receiving dental care.
Many patients think that their insurance pays 90%-100% of all dental
fees. This is not true! Most plans only pay between 50%-80% of the
average total fee. Some pay more, some pay less. The percentage paid
is usually determined by how much you or your employer has paid for
coverage, or the type of contract your employer has set up with the
insurance company.
Fact 2 - BENEFITS ARE NOT DETERMINED BY OUR OFFICE
You may have noticed that sometimes your dental insurer reimburses
you or the dentist at a lower rate than the dentist's actual fee.
Frequently, insurance companies state that the reimbursement was
reduced because your dentist's fee has exceeded the usual,
customary, or reasonable fee ("UCR") used by the company.
A statement such as this gives the impression that any fee greater
than the amount paid by the insurance company is unreasonable, or
well above what most dentists in the area charge for a certain
service. This can be very misleading and simply is not accurate.
Insurance companies set their own schedules, and each company uses a
different set of fees they consider allowable. These allowable fees
may vary widely, because each company collects fee information from
claims it processes. The insurance company then takes this data and
arbitrarily chooses a level they call the "allowable" UCR Fee.
Frequently, this data can be three to five years old and these
"allowable" fees are set by the insurance company so they can make a
net 20%-30% profit.
Unfortunately, insurance companies imply that your dentist is
"overcharging", rather than say that they are "underpaying", or that
their benefits are low. In general, the less expensive insurance
policy will use a lower usual, customary, or reasonable (UCR)
figure.
Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED
When estimating dental benefits, deductibles and percentages must be
considered. To illustrate, assume the fee for service is $150.00.
Assuming that the insurance company allows $150.00 as its usual and
customary (UCR) fee, we can figure out what benefits will be paid.
First a deductible (paid by you), on average $50, is subtracted,
leaving $100.00. The plan then pays 80% for this particular
procedure. The insurance company will then pay 80% of $100.00, or
$80.00. Out of a $150.00 fee they will pay an estimated $80.00
leaving a remaining portion of $70.00 (to be paid by the patient).
Of course, if the UCR is less than $150.00 or your plan pays only at
50% then the insurance benefits will also be significantly less.
MOST IMPORTANTLY, please keep us informed of any insurance changes
such as policy name, insurance company address, or a change of
employment.
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Pediatric Dental Associates
~ Dr. Michael S. King.
Serving patients in the surrounding cities and suburbs of New York, NY.
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© 2008 ~ Michael S. King,D.D.S. ~ All rights reserved.
Pediatric Dentist serving infants, children and teens in New York, NY
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