Frequently Asked Questions

• How does your office schedule appointments?

• Do I stay with my child during the visit?

• What about finances?

• What are your guidelines regarding dental insurance?

• What are some dental insurance facts to keep in mind?

• How does your office schedule appointments?

  We try to schedule appointments to maximize children's positive response and minimize missed school time. We know that younger children perform better in the mornings, which happily allows afternoons for school-aged children. We also schedule special "Toddler Time" for our youngest new patients and their parents. Please keep in mind that health care visits are excused absences and we will be happy to provide your child with a school excuse for their visit.

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• Do I stay with my child during the visit?

  Since our establishment in 1986, our experience in pediatric dentistry has shown us that most children age four and over react best when they are allowed to experience the dental visit on their own. However, if your child is under the age of four, we will likely ask that you accompany your child for their first visit. Our team is specially trained to work with children and our office is designed to be comforting for children as well.

  We believe establishing a fun and caring relationship with you and your child will create a positive dental experience and motivate them to maintain proper oral hygiene. You don’t need to worry about your child while in our care; a team member will assess your child’s medical history to address any questions or specific medical conditions. Prepare your child for a fun visit with us! They will get to meet our wonderful team and Freddy the Frog!

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• What about finances?

  Payment for our services is expected at the time dental treatment is provided. Your child will receive the best possible dental care and we make every effort to provide a treatment plan that fits your budget and schedule. For your convenience, we accept cash, personal checks, Visa, MasterCard, Discover, and American Express. We also offer third party financing through Care Credit.

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• What are your guidelines regarding dental insurance?

  We would be more than happy to file insurance as a courtesy to our patients. However, the contractual obligation is between you, the responsible party, and your insurance carrier. We suggest you take some time and familiarize yourself with your insurance benefits, as you will be expected to pay any amounts that your insurance does not cover.

  The Kids’ Dentist files insurance electronically, so your insurance company will receive your claim within hours of your visit. By law, insurance companies are required to pay each claim within 30 days of receipt. However, if a claim is unpaid, it may become your financial responsibility and The Kids’ Dentist cannot be held responsible for how your insurance company handles the claim or for the amount paid.

  We can only offer assistance in estimating your portion of the cost of treatment. We do not guarantee what your insurance will or will not cover with each claim. Once again we file claims only as a courtesy to you.

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• What are some dental insurance facts to keep in mind?

  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.

It is also important to note that having multiple dental insurances does not guarantee that 100% of services will be covered.
  
  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 "exceeded the usual, customary, or reasonable fee" ("UCR") used by your insurance 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 by the insured.

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