Billing and Insurance FAQ

I have Insurance. Why did I still get a statement?
What can I do if I feel my insurance company made a mistake?
There are a few times that your carrier may make a mistake with your claim (not many). Generally, claims are automated and electronic. Your carrier's computers simply apply the rules that you have paid for with your plan and pay accordingly. If the service is not covered by your plan, it will likely not be paid regardless of how earnestly you believe it should. Some claims for more complex procedures are hand reviewed. Despite what you might think, they are not reviewed by a doctor the first time in most cases, just a data entry clerk. In these cases, if you request that the company re-review your claim with a consultant, they may reopen the claim for you. Usually they will then require more information. Make sure that you keep a record of all correspondance and make a list of what you will need. We will be happy to send you the information you need to refile your claim. If you get any additional payment sent on your behalf, we will credit your account appropriately and refund any excess amount.
What is my responsibility if my insurance does not pay the claim?
The financial obligation for your dental treatment is yours. The insurance company is responsible to you, and not to our office. We will assist you in any way that we can, but please know that we do not work for any insurance company and therefore cannot guarantee their payment. Once your carrier has paid the claim, any difference will be due upon receipt of our statement. If, for any reason, we have not received your insurance carrier's payment within 90 days after submitting the claim, the remaining balance will be due and payable by you. Balances over 90 days old are subject to 18% APR.
What is an EOB and how do I read it?
An EOB stands for "Estimate Of Benefits" and is a statement from insurance company which is generated whenever a claim or pre-estimate is filed on your behalf. Your member booklet, human resources department or your insurance carrier can better explain how to read your EOB as they are all different. In general, it will show you the submitted amount, the insurance downgrades (if any), the percentage of coverage and your financial responsibility. Downgrades or exclusions will usually be coded with a letter or number. A key can be found somewhere in the EOB package which details the reasons for those exclusions. Please remember that you will recieve your EOB up to 3 weeks before we will.
What if I wind up with a credit on my account?
We process credits every 2-3 weeks for accounts where all outstanding claims have been closed. Unless you specify otherwise, we will promptly send you a refund check for the amount that was overpaid.
I just recieved an EOB and and a delinquent account notice at the same time. Why?
It is standard practice for a store to bill a customer the day that they buy something. In the same way, our system calculates the number of days your balance is outstanding from the day we performed the treatment, not from when your insurance company makes their determination. If your carrier has delayed their decision by 60 or 90 days, your account balance may show as delinquent when the claim is closed. We apologize for any inconvenience this may cause.
How can I pay my bill?
You may pay your bill by mail with a check or money order or, in person. We also accept Mastercard, Visa, Discover and Amex and you are welcome to pay by telephone. Lastly, if you have a Carecredit, Chase Credit or similar, you may authorize payment by telephone as well.