Insurance Information

A dental benefit plan is designed to share in your dental care costs. It may not cover the total cost of your care. Most plans cover between 50 and 80% of dental services. A dental plan is a contract between your employer and a third party (insurance company). There are many different kinds of dental plans and reimbursement levels. While we are not a party in these contracts, we do have numerous staff members with nearly 100 years combined experienced in estimating the benefits of dental plans. We are proud of our ability to unravel the mysteries and benefits of your particular plan.

We expedite our claims filing process by submitting claims electronically when an insurance company accepts this format. Additionally, we provide follow-up replies and documentation to your insurance company electronically if they are able to accept them. We are preferred providers for Cigna Radius Network, Humana, Anthem, WEA, Ameritas, Principal, Guardian DentalGuard PPO and the Dental Health Alliance (which includes Assurant PPO and Aetna PPO plans) and premier providers for Delta Dental.

If your dental plan is not part of one of these networks you can still utilize our services. Most dental plans will allow you to seek dental care outside of their network and most do not reduce your benefit level for doing so. Our staff can advise you about your dental benefit plan and your ability to seek out of network dental care.

If you have insurance benefits and assign benefits to us, we will manage your account as follows:

• No administrative fee will be assessed for filing insurance claims; we will provide this service as a courtesy.
• You must provide our dental staff with accurate insurance billing information at the time of your appointment, or you will be responsible for payment in full. (When possible we prefer to receive insurance information in advance of your appointment so that we can avoid delays in estimating your benefits at the time of service.)
• Our administrative staff will research insurance benefits and estimate coverage based on our insurance expertise. We do not guarantee our benefit estimates to be correct and are not responsible for benefits that are not paid exactly as estimated.
• You are responsible for paying deductibles and estimated co- payments when making appointments. You are also responsible for paying all charges not covered by your insurance plans, including all fees considered above your insurance policy’s usual and customary fee schedule.
• Information requests to you from the insurance company and/or our practice must be promptly responded to.
• The office will submit a claim to an insurance company up to two times per appointment for the purpose of obtaining payment. Further insurance appeals are your responsibility.
• Insurance benefits are a contract between the patient and his/her employer. The coverage a patient will receive depends upon the quality of the plan purchased by his/her employer, not the fees of the doctor. You are financially responsible for all services provided at First Choice Dental. Any insurance benefit not paid as estimated is your responsibility.
• If your balance after insurance payment is under $5 it will be collected on your next visit to our practice. A statement for balances over $5 will be mailed to your account address and will be due within 30 days of billing.