Patient Forms

Dental Claim Form

Dental Insurance

If you belong to a traditional insurance plan we can assist you by filing your insurance claim. Traditional insurance is typically one in which you can choose any dentist you desire. Our practice does not belong to any PPO or DMO insurance plans. If you are not sure what type of plan you have, we will be happy to call for you and explain your benefits to the best of our ability.

In an effort to provide high quality dental care and to clarify our position on filing for your insurance benefits, we would like to share some facts about dental insurance with you:

• Your dental insurance is based on a contract between your employer and the insurance company. While we will attempt to estimate your dental benefits to the best of our ability, this is an estimate ONLY, and should not be depended on as the final decision. Should questions arise, it is best to contact your insurance company directly.
• You may receive notification from your insurance company stating dental fees are “higher than usual and customary”. An insurance company surveys a geographic area, calculates an average fee and then takes that fee and considers it customary. Included in this survey are discount clinics and managed care facilities, which bring down the average. Most doctors in private practice will have fees, which are defined as “above usual and customary”.
• Many plans tell participants they will be covered “up to 80% or up to 100%” but do not clearly specify plan fee schedule allowances, annual maximums or limitations. Insurance companies do NOT cover all dental services.

If you have any questions about the above information or any uncertainty regarding insurance coverage, PLEASE do not hesitate to ask us. WE are here to help you!