Payment and Office Policies
Cost
The cost of treatment depends on the severity of the patient’s problem. You will be able to discuss fees and payment options before treatment begins.
We try to ensure that cost is not an obstacle for your care, we are happy to create flexible payment arrangements to fit your budget. We also accept assignment from most insurance plans and file the necessary papers to the insurance company. We work hard to make orthodontics affordable. We are in contract with certain insurances, please make sure to call our office for our insurance list.
Fees
In an effort to keep orthodontic fees down while maintaining the highest level of professional care, we have established this financial policy:
- If full payment is made at the onset of treatment, we will offer a fee discount. (If you have insurance, we will offer a discount for payment of your portion of the fee that will not be covered by insurance.)
- To fit your individual needs, financial arrangements can be made to extend your payments over a period of months.
- For your convenience, we accept payment by Visa, MasterCard, Discover, American Express, and CareCredit (outside patient financing).
- In cases of serious delinquency, treatment will be discontinued, although we will make every effort to accommodate patients who have temporary difficulties.
Insurance
If you have insurance, we will help you to determine the coverage you have available. We ask that you assign your insurance benefit to us. The balance will be arranged for you to pay (see above).
Professional care is provided to you, our patient, and not to an insurance company. Thus, the insurance company is responsible to the patient and the patient is responsible to the doctor. We will help in every way we can in filing your claim and handling insurance questions from our office on your behalf.
Understanding Your Orthodontic Insurance
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ELIGIBILITY: Your employer may offer orthodontic coverage, but that doesn't mean you are eligible. Some policies require you to work a minimum number of hours per week, or there may be a 6-12 month waiting period for a new employee. |
STARTING DATE: The start date is the date the appliances/braces are placed on teeth. Your insurance will need this date in order to process claims. |
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BENEFITS: Every plan offers a different level of benefits. Generally, an orthodontic benefit is separate from your regular dental benefit. In most cases, orthodontic benefits have a one-time use benefit. It's important to note that maximums rarely cover half of a full comprehensive fee. |
LOSS IN COVERAGE Please be aware that any unpaid balance by your insurance company will be transferred to your balance. |
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TWO PHASE TREATMENT: In the case that our office recommends two phases of orthodontic treatment, our office may only receive a portion of your insurance benefit for phase I. Any unused benefit may be applied towards phase 2 as long as the policy is still active. |
WORK IN PROCRESS: Please inform our office immediately of any new coverage so we can submit a claim in a timely manner. It's not unusual for your new insurance company to prorate your benefit based on what the prior coverage paid and/or remaining treatment time. Note: Not all plans allow for work in progress. |
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PAYMENTS: It is important to note that orthodontic benefits are rarely ever paid out upfront. Depending on your insurance company, payments will be spread out over the course of treatment in monthly, quarterly, or yearly installments. Therefore, coverage MUST remain active throughout the course of treatment to receive the full benefit. |
DUAL COVERAGE: Double coverage occurs when a patient is enrolled in two active policies. Our office will do our best to help determine how much each policy should pay. Note: Some exclusions may be present on your policy making it impossible to collect on both. |
ADDITIONAL PROCEDURES:
If extractions or exposures are needed to accomplish orthodontic treatment it is important to note that your policy may combine these procedures with your orthodontic maximum. Therefore, our office will not receive the full anticipated benefit and the remaining will be transferred to your balance.
