Payment Options
Insurance Claims
We file dental insurance as a courtesy to our patients. We do not have a contract with your insurance company; only you do. Therefore, we are not responsible for how your insurance company handles its claims or for what benefits they pay on a claim. We will assist you in estimating your portion of the cost of treatment, but we cannot guarantee what your insurance will or will not cover for each claim. Although we make every attempt to file claims accurately and to resolve errors if they occur, we cannot be responsible for any errors in filing your claims.
Insurance
We are out of network with most insurance plans. If you have coverage, we will bill your “out-of-network” dental plan, although there are unique rules depending on your insurance company and your plan. If you have any questions or concerns about your particular insurance plan, do not hesitate to contact the office. As a courtesy to our patients, we will be happy to file a claim on your behalf but ultimately the responsibility for payment of the claim belongs to the patients.
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Did you know? The services and amounts paid that a dental plan covers is determined by your employer at the time that they choose the plan, so if you have any benefits covered less or denied, your employer is ultimately responsible for unfavorable outcomes!
Please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment status.
*IMPORTANT NOTE ABOUT INSURANCE COVERAGE: Insurance providers we work with may change at any time and without notice. If you have any questions regarding your insurance provider, please contact our office at (206)251-7638. Thank you.
Co-Payment
You may have noticed that sometimes your dental insurer reimburses you or our office at a lower rate than the actual fee incurred. Frequently, insurance companies state that the reimbursement was reduced because the fee has exceeded the usual, customary, or reasonable fee (“UCR”) used by the insurance company. The data used to establish fees may be dated and are set by the insurance company so they can make a profit, too.
Insurance companies set their own schedules, and each company uses a different set of fees. These allowable fees may vary widely because each company collects fee information from claims it processes. The insurance company then uses this data to establish their fee schedule. Depending on the type of insurance you have and the exact nature of the plan, you may be responsible for the difference in what the insurance company pays and the fee assessed for services provided. 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.
Payment is expected at the time services are provided by the person(s) accompanying the patient unless other arrangements have been made with our office in advance. In the event reimbursement is expected from a third party, it is the responsibility of the person(s) making the appointment and bringing the patient to the office to pay for services rendered and obtain reimbursement from third parties. Lakeview Kids’ Dentistry will not be responsible for obtaining payment from third parties.
Additional Financial Information
- No insurance pays 100% of all procedures
- Benefits are not determined by our office
Keep in mind that dental insurance is meant to be an aid in covering dental care. On average, most dental insurance plans pay between 50%-80% of the average total fee. Some plans pay more, some pay less.
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. You should 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 claims in a manner such that your insurance company will receive claims within days of the treatment. 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 $20 will be added to your account each month until paid. If you have not made payment arrangements with our office within 90 days of services being provided, your account may be frozen and referred for collection. In the event payment cannot be made in full within the above referenced time frames, please call the office to discuss alternative payment plans. We will make every attempt to accommodate your situation.
Credit Cards
Our office accepts Visa, MasterCard, American Express and Discover cards.
Payment Plans
We expect all patient portions and deductibles to be paid when service is provided. We implemented and enforce this policy to keep costs down for each of our patients. Prior to treatment, our staff will provide an estimate of the treatment costs or co-pay. Usually the co-pay is a close estimate but in some cases an additional amount will be due. In the event extensive treatment plans are required, financial arrangements can be discussed on an individual basis.
