Office Policies:
Our office attempts to schedule appointments at your convenience within the available time.
New patients will be scheduled mostly in the mornings since we have more time to spend with them at that time. We want to give your child and you as much time and attention as possible for this crucial appointment. New patient appointment usually involves filling out medical health and other forms, getting to know our office, tell-show-do approach for the kids to get familiar with our procedures, and an information session for the parent with the doctor and the staff members.
Younger children, such as preschoolers should be seen in the morning because they are less tired and we typically are less busy when older children are at school. This way we can spend all the time they need accommodating for their needs.
School children with a lot of dental work to be done should be seen in the morning for the same reason. We will provide you with a school note and dental appointments are an excused absence.
Sedation appointments will also be seen in the mornings because children must be without food that morning and we do not want to keep them hungry. Children are usually more rested and comfortable at that time. We also want to give them the rest of the day to recover from the sedation medications that they will take in the morning.
Since appointed times are reserved exclusively for each patient we ask that you please notify our office 24 hours in advance of your scheduled appointment time if you are unable to keep your appointment. 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.
We welcome parents to our initial exam appointment, to our consultation area following each appointment and to visit our office for an office tour. However, we ask that you allow your child to accompany our staff through the dental experience. We are all highly experienced in helping children overcome anxiety. Separation anxiety is not uncommon in children, so please try not to be concerned if your child exhibits some negative behavior. This is normal and will soon diminish. 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.
It is very important however, that you do not leave the office during your child’s dental treatment. Situations may arise where we must speak to the parents about changes in treatment or emergency situations.
Payment for professional services is due at the time dental treatment is provided. Every effort will be made to provide a treatment plan which gives your child the best possible care and fits your timetable and budget. We accept cash, debit cards and most major credit cards. We do not take personal checks.
If we have received all of your insurance information on the day of the appointment, we will be happy to file your claim for you as a courtesy. HOWEVER, WE ARE NOT A PARTICIPATING PROVIDER ON ANY DENTAL PLANS. THIS MEANS YOU ARE RESPONSIBLE FOR THE DIFFERENCE BETWEEN OUR FEE AND THE INSURANCE ALLOWABLE FEE.
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. You are responsible for any balance on your account after 30 days, whether insurance has paid or not. If you have not paid your balance within 60 days a finance charge of 2% will be added to your account each month until paid unless other arrangement with our office have been made. In case that you pay and your insurance reimburses us later, we will be glad to send a refund to you.
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. We are not responsible for how your insurance company handles its claims or for what benefits they pay on a claim. 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.
INSURANCE FACTS:Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 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.
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.
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.
E-Mail: DrKasia@smiles-for-kids.com

