Thank you for understanding that we file dental insurance as a courtesy to the parents and guardians of our patients. We can provide assistance with estimating your portion of the cost of treatment. However, we at no time guarantee what your insurance will or will not cover on each claim that is filed.
Checklist to assist you in preparation for your child’s first visit with us.
- Be sure your child can currently receive benefits from your dental insurance policy. It may be necessary to add a child if there has been any changes to the policy or the policy is new.
- Please bring to our office a current insurance card that includes the following: ID number, Group number and the address and phone number for the insurance company. Some dental insurance plans do not issue a card; therefore we will need the social security number and date of birth for the parent who carries the policy.
- The person who carries the insurance is the subscriber and may or may not be the parent with whom the child resides. We will need the subscriber’s date of birth and employer information to expedite the processing of the claim.
- You may choose to contact your insurance company, in advance, to verify benefits. This will enable you to become familiar with your particular plan and allow you to anticipate your level of benefits.
Important Insurance Facts to Know
- Fact #1: No insurance pays 100% of ALL procedures-many parents assume their insurance pays 90%-100% of all dental fees. Most plans only pay between 50%-80% of the average total fee. Some pay more, some pay less.
- Fact #2: 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 #3: 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 inaccurate. Insurance companies set their own schedules and each company uses a different set of fees they consider “allowable”.
- Fact #4: In keeping with contemporary choices for aesthetics and environmental reasons we use composite resin or white fillings at our office. Some insurance companies do not pay for a white filling at the same level as a silver filling (amalgam). The difference between the two fees will be your responsibility.
- Fact #5: There are some insurance plans where their policy is that they pay you (the subscriber) directly. Some of these may include but not be limited to: some Private/Individual Plans, Delta Dental, and Blue Cross Blue Shield. Therefore, you will be responsible for total payment on the day of service. We will file your insurance for your direct reimbursement by your insurance company.
Included in this list are some of the insurance companies that may cover a portion of your dental treatment done at World Pediatric Dental. If your dental insurance carrier does not appear below, we would be happy to find out if your insurance company will cover work done here at the office. Whether we are considered to be in or out of network with your insurance depends on your actual dental plan. Our experienced Insurance processing staff will be happy to work with your insurance company to secure your dental benefits.