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 the child 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 48 hours in advance of your scheduled appointment time if you are unable to keep your appointment. We reserve the right to apply a $50.00 no show or less than 48 hr cancellation fee. 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.
Our objective is to always get patients in at the time scheduled. As parents, you are well aware that children do not always allow us to achieve the goals planned for them as intended. In Pediatric Dentistry those obstacles are much more magnified by virtue of the nature of the work. Our office operates on “children’s time”. This means that some of our patients may unpredictably need extra time to be made more comfortable and less apprehensive. As much as we try to stay on schedule, “children’s time” will invariably cause some delays. Because of this, we do apologize for running behind, occasionally. Be reassured that we are taking care of your child in the same kind and caring manner.
Do I Stay with My Child During the Visit?
We invite you to stay with your child during the initial visit. 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. Experience has shown that children tend to do better when their attention can be focused in one direction. We have extensive training in behavior management and will work with your child in a way that allows them to understand each step of the visit.
Our purpose is to gain your child’s confidence and overcome apprehension. Studies and experience have shown that most children over the age of 3 react more positively when permitted to experience the dental visit on their own and in an environment designed for children. For the safety and privacy of all patients, other children who are not being treated should remain in the waiting room with a supervising adult.
About Finances and Dental Insurance we Provide For
Payment for professional services is due before services are rendered. Please be aware that the parent bringing the child to our office is legally responsible for payment of all charges. We cannot send statements to others. Please understand that payment of your bill is considered a part of your child’s treatment. While we will accept assignment of benefits from your insurance company, you will be responsible for the full balance including any amount that is not paid by your insurance company. If your insurance covers 100% of preventative treatment, there is typically no charge up front for new patient visits. As a courtesy, our staff is happy to verify your specific insurance plan information prior to you coming to our office. We are not able to verify your insurance at the time of your child’s visit because the time of the appointment is for the doctor to take care of your child. Please provide your insurance information when booking the appointment so that our staff can verify your benefits and explained them to you prior to your child’s appointment day.
We accept cash, debit cards, Discover, MasterCard, or Visa. Additionally, for ORTHODONTIC Treatment, we offer easy interest-free payment plans. Please let us know if you would like more information.
DENTAL INSURANCE WE PROVIDE FOR: Metlife, Aetna PPO, Cigna PPO, Delta Dental PPO, Nippon, Guardian PPO, Principal PPO, Ameritas, Assurant, Empire, Blue Cross Blue Shield, Lincoln Financial, United Concordia, Sunlife Financial, Coresource, Humana, 21st Century.
If you do not see your Insurance Plan here please call us at (212)757-9653. If you have any questions or uncertainty regarding your insurance coverage, please don’t hesitate to call us. We are here to help you.
Our Office Policy Regarding Dental Insurance
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. 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. There is no direct relationship between our office and your insurance company. The type of plan chosen by you, and/or your employer determines your insurance benefits. As such, we have no say in the selection of your insurance company, no control over the terms of your contract, the methods of reimbursement or the determination of your insurance benefits. We will accept assignment of benefits from your insurance company, however you are responsible for the full balance including any amount that is not paid by your insurance company. 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.