FAQ's
Insurance related questions:
Why do I have to come in for a consultation and pay for another office visit when I just had one with the dentist who referred me to you?
We are unlike your dentist in that we are a specialty office and we usually only see our patients for one procedure. Your dentist has an ongoing relationship with you and is familiar with your history. You are a new patient to us so it is important for our doctor’s to meet with you to review your medical history, past surgery information, and review any allergies you may have. We also want you to feel comfortable with your procedure and this gives you a chance to meet your doctor and have any of your questions answered before you come in for your surgery appointment.
Why do I need a new x-ray taken if I just had x-rays taken at the dentist?
Dental x-rays are generally bite wing or full series x-rays that are used to look at an individual tooth. We need a current panorex x-ray in order to see the entire anatomy of your jaw (sinuses, nerves, roots, etc.) We also need to make sure that your x-ray was taken within the past year as your root structure continues to grow and your tooth position can change with growth as well.
Why do you charge different prices for teeth extractions?
Our pricing is dependant upon the tooth location and the degree of difficulty in extracting each individual tooth. Some teeth are above the jaw and gum line and are easy to extract where as some teeth can be impacted in the gum tissue or jaw bone making their extraction much more difficult.
Will my medical insurance pay for wisdom teeth?
Some plans do provide coverage for wisdom teeth but there are certain guidelines that have to be met. Since all carriers are different, it is best to contact them before hand to see if you have coverage and what criteria must be met. (Ex: Coverage is only allowed for impacted wisdom teeth).
Do you take my insurance?
We accept all insurance companies and will file your claim for you; however, we are contracted with only MetLife, Delta Dental Premier and Guardian dental insurance companies, and Kanawha medical insurance. If your insurance is with another carrier, you will need to make sure that they will allow you to come to us and that you do not have to see an in-network provider.
What if I have a managed care plan?
We are a specialty provider so it is different than going to your primary care doctor where you might pay a co-pay. You will need to call your insurance companies member services and see if your plan has out-of-network benefits if you have anything other than the plans we are contracted with.
Can you tell me how much my insurance will pay for my procedure?
At your consultation visit we will give you an estimate of your surgery fees. If time allows, we will be glad to submit a pre-determination to your insurance company to get their estimated payment amount. Please keep in mind that this can take up to six weeks to get a response from most insurance companies on this.
I received a statement for my surgery/office visit. Have you billed my insurance company yet?
Yes. Sending out statements is our way of communicating to all of our patients what claims have been paid and what has not. If you are receiving a statement and it has not been 30 days since your procedure/office visit please refer to the bottom left corner of your statement. It will tell you when we last filed your insurance. If you receive another statement indicating the same balance please contact your insurance company first to ensure that a claim has been received.
Why do I have a balance due after my insurance? I paid what I was asked to on the day of my surgery.
When you come in for your consultation you are given a treatment plan that indicates the payment we ask for upfront before filing your insurance. This amount is an ESTIMATE. We then file your insurance for you and any balance is billed to the patient. Balances occur when you have exceeded your calendar year maximum, have no coverage for the procedure, have lower coverage than anticipated, etc. We encourage all patients to have a pre-treatment estimate filed if you would like a better idea of your out of pocket expense. Even with the pre-treatment estimate it is still only an ESTIMATE. If you feel that your insurance processed your claim in error please contact them directly.
Where is my refund? Since I paid you in full, why is my insurance company paying you?
Refund checks are issued weekly. Once your insurance company pays us we will refund the guarantor the credit on the account in the form of a check from us. Please remember that we are only contracted with Metlife Dental, Delta Dental, Guardian Dental, and Kanawha Medical insurance companies. If you do not have this insurance we will ask for payment in full for consultations, and tooth extractions performed on the same day as the consultation. As a courtesy our office files out of network claims. We request payment sent to us so we can follow the claim and follow up with any information requested. Once we receive payment we will refund you the credit. If you would like payment sent to you please let us know and we will be happy to supply the information for you to file a claim to your insurance company directly.
My insurance company has requested information for my claim, can you send it for me? Have you filed my secondary insurance?
Insurance companies send all correspondence to you first. You will receive estimation of benefits (EOB’s) 3-7 days before we will. Once we receive the EOB we will attach the necessary information to the claim for you and re-file your claim. Once we settle the claim with your primary insurance we will gladly file your secondary claims. Please make sure that you give the front desk all of the information in order for us to do this. However, it is important to remember that filing multiple insurance companies can slow down the processing of your entire claim and the balance on the account is due within 60 days of the date of service.