Insurance & Payment
We specialize in understanding dental insurance
Dental Insurance: Are you in or are you out...of Network?
Understanding dental Insurance is one of our specialties and helping you get the most out of your plan is to your benefit if the need for treatment arises. We are proud to be part of some of the countries largest Dental Insurance providers. Some of the Preferred Provider Organizations (PPO) that we are a part of:
By choosing to be part of these PPOs, we can help reduce some of the costs of your dental care. The estimated amount we expect your plan to reimburse us is accepted as a form of payment but any deductibles and co-pays are due at the time of service. As a courtesy to you, we will bill your insurance company first and any remaining costs will be owed directly by you. In the event that your child needs to have treatment (fillings, crowns, etc.) completed, we will submit a predetermination (Pre-D) to your insurance company to acquire a truer to life estimated cost of the prescribed treatment.
We file all insurance claims electronically to your insurance company and we will have your claim within days of treatment. We utilize a computer program to estimate the benefits and estimated co-pays provided by your plan. Please understand this is only an ESTIMATED amount and is not a guarantee of complete payment. Your insurance plan only guarantees payment after each visit and after it has been reviewed by them.
We can only assist you in estimating your portion of the cost of the treatment. We are unable to guarantee how your insurance company will process each claim submitted. Employers have the opportunity to frequently change insurance plans and it is your responsibility to inform us of any changes since your last visit. Please keep us informed of any changes, as they may significantly affect your benefit level. We suggest you contact your insurance carrier directly for more definitive information regarding your costs; including the breakdown of benefits, copays, and deductibles. IT IS YOUR RESPONSIBILITY TO UNDERSTAND ALL BENEFITS AND AGREEMENTS PERTAINING TO YOUR INSURANCE POLICY.
We try to help you navigate your insurance benefits as a service to you. Please let us know if you have questions.
Insurance companies provide benefits using online portals, telephone, and via fax. Due to this process, verifying insurance can take up to 30 mins or more, and so to ensure a more comfortable visit we verify insurance before your appointment time. Verifying insurance at the time of visit may result in longer wait time or rescheduling of your appointment.
Do you still have questions about insurance? Please fill out our contact form for any further questions
Do you have an HMO?
At this time, the only Health Maintenance Organization (HMO) insurance we accept is DeltaCare USA. As a DeltaCare USA member, you and your family are automatically assigned a general dentist by your zip code. In order to be seen at any specialty office as a new patient, you will need to obtain a specialty referral which is provided to you by your assigned dentist. Once you have received the specialty referral for your child, you may give us a call to schedule an appointment.
Did you know?
Pediatric Oral Wellness is proud to partner with DeltaCare USA to provide stellar Pediatric Dentistry! As a specialty office, you will need a referral from the General Dentist you were assigned by DeltaCare. In order to schedule your appointment, please have the referral sent to our office prior to scheduling to allow you to schedule the appointment as soon as possible. DeltaCare USA is part of the Delta Dental family of products and offers its’ patients access to quality care, at affordable prices. DeltaCare USA allows you to see any specialist you wish, as long as a referral is obtained prior to visiting the specialist (Pediatrics, Orthodontics, Endodontics, Oral Surgery, etc.) of your choosing.
If you have specific questions regarding your plan, please call DeltaCare USA at 1.800.422.4234 or log on to http://www.deltadentalins.com
Should your child require dental treatment, these needs will be discussed with you by one of our staff members. In most cases, an additional appointment(s) will be needed to complete the treatment. The payment amount provided to you on your child’s treatment plan is an estimate only, and you may be asked to pay the difference between what your insurance company actually paid and the fees incurred at the time of service.
Financial Policy & Payment
Payment is required at the time services are rendered. We accept cash, checks, Master Card, Visa, Debit, and Care Credit as forms of payment. There will be a $35 fee for returned checks.
As a courtesy, we will file a claim to your primary insurance for you. You will be responsible for the remaining balance not covered by your insurance company, including all fees considered above your insurance company’s usual and customary fee schedule. The office cannot carry balances longer than 90 days, regardless of insurance payment.
All services will be charged on the day of the procedure. You will only be charged for services rendered at the visit. Our financial personnel will go over the proposed treatment plan.