We love our patients at Mountain Kids Pediatric Dentistry! To make sure you love us too we have a few policies in action to establish expectations and assure superior customer satisfaction.
We attempt 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 the child 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 24 hours in advance of your scheduled appointment time if you are unable to keep your appointment. 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.
You are welcome to stay with your child during the initial examination. We want to establish a trusting, comfortable relationship with your child and hope they eventually want to go back to the clinic area on their own. For the safety and privacy of all patients, other children who are not being treated should remain in the waiting area with a supervising adult.
If you would like us to submit to your dental insurance, we require that you supply your insurance information to us on or before the day of the appointment. We will be happy to file your claim for you. It is important for you to 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 all insurance electronically so your insurance company will receive each claim within days of the treatment. You are responsible for any balance on your account after 30 days, whether insurance has paid or not. We will be glad to send a refund to you if your insurance pays us. Please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.
PLEASE UNDERSTAND that we file dental insurance as a courtesy to our patients. We are not responsible for how your insurance company handles its claims or for what benefits they pay on a claim. We can only assist you in estimating your portion of the cost of treatment, we at no time guarantee what your insurance will or will not do with each claim.
Interesting facts about Dental Insurance
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. Unfortunately this is not true. The percentage paid by your insurance company 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.
BENEFITS ARE NOT DETERMINED
BY OUR OFFICE
Insurance companies set their own fee 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.
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).