Thank you for choosing Children's Dentistry of North Dallas as your trusted source for pediatric dentistry in Dallas, Texas. Prior to your child’s first appointment, please review the following office policies:
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 them 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 or a $50 fee will apply. 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.
Do I stay with my child during the visit?
We invite you to stay with your child during the initial examination. Parents play a very important support role in the dental health of each child. As the child becomes more familiar with the office, they may be able to be seen unsupervised. Our purpose is to gain your child’s confidence and overcome apprehension. Other children who are not being treated are invited to remain in the reception room with a supervising adult to watch a movie and play.
What about finances?
Payment for professional services is due at the time dental treatment is provided. Every effort will be made to provide a treatment plan which fits your timetable and budget, and gives your child the best possible care. We accept cash, personal checks, debit cards, Visa and Mastercard. For your convenience, we provide third party financing through CareCredit as well.
Our Office Policy Regarding Dental Insurance
We request that we receive up-to-date insurance information prior to the day of the appointment. 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. We prefer the appointment day to be reserved for clinical matters. All business matters should be received before the appointment. By law, any procedures not covered by the dental insurance can be collected at the dentist’s usual and customary fee instead of the insurance’s contacted amount. Insurance pays us.
It is our goal to help you receive the maximum benefits available under your dental insurance policy. We request you read and understand your dental plan benefits prior to seeking treatment. You must provide the office with the proper dental insurance information. If we have not received this information one business day before the scheduled appointment, you will be responsible for payment of all fees and a claim will be sent to the insurance for them to send your reimbursement. Your insurance benefits are a contract between you and your employer. The amount of coverage you will receive will depend on the quality of the plan purchased by your employer, not the fees of the doctor. Your deductible and the estimated portion not covered by your insurance are due at the time services are provided. As a courtesy to you, we will file your claims with your primary insurance company, but need your cooperation. If payment from your insurance company is not received within 60 days from the date the claim is submitted, you will be required to pay the balance and follow-up with the insurance company. A new bill, Texas Senate Bill 554, was passed into effect on September 1,2011 states any procedures not covered by the dental insurance can be collected at the dentist’s usual and customary fee instead of the insurance’s contacted amount.
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.
You are welcome to contact our office if you have any questions or need to arrange a visit with our pediatric dentists. Drs. Holly, Iwase and Shah and our team are committed to providing a convenient, pleasant visit for all our patients and their parents, and we are happy to address your concerns in advance.