At Dentistry at Pelham Pointe we make every effort to provide you with the finest care and the most convenient financial options. To accomplish this we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures.
We are delighted to file your primary insurance once coverage has been established, however dental benefits are your responsibility. We will try to help you calculate your benefit in dollars, with any co-payment and deductible due at the time of service. Since this is an estimate, even with a pre-determination there can be no guarantee of what your insurance company will pay and this may result in a credit or balance due. Credits may be applied to future treatment or a refund may be requested. If there is a balance due, you will receive a statement.
If your insurance has not paid in 30 days, we will re-file your claim. After 60 days or if the claim is denied, the full balance becomes your responsibility. Our insurance coordinator will be glad to answer any questions about your dental coverage, including secondary insurance or medical benefits.
Prior to your initial visit, please provide your insurance information with you so that we can expedite reimbursement. For our current patients, if you have had a change in your dental insurance since your last visit, be sure to provide us with updated information.
Frequently Asked Questions…
Why is your name not on my list of Preferred Providers?
We do accept most insurance plans; however, you will not find our name on any PPO list of providers. To date, we have not seen any of these PPO plans that are designed with your health in mind. They are designed to do dentistry as quickly as possible and sell it as cheaply as possible. We pride ourselves on making treatment recommendations based on what we feel is in the best interest of the patient, not based on what an insurance plan will pay.
Why does my dental insurance not pay more?
Our office has always been happy to work with patients covered by dental insurance. We think insurance is a great incentive to maintain a vital level of dental health. But it’s a rare – very rare – dental plan that covers 100% of our fees. Here’s why. The fees we charge for dental services are the same for every patient, insured or not. A given insurance policy, however, is based on a fixed fee schedule – “usual and customary” – that may have nothing to do with the real world. Dentistry has changed very quickly, but insurance fee schedules have not. In 1972, the maximum annual benefit for one of the most popular dental insurance companies at the time was $1000. This same company is in business today and their maximum annual benefit for the majority of their policies is still $1000. Insurance companies are profitable businesses, not dental benefactors. Further, insurance companies reimburse you an amount they figure is commensurate with average quality dentistry in an average office with an average staff, “average” falling somewhere between the best dentistry and the worst dentistry. Well, we have a better opinion of our services. Our belief is, and always has been, that the style and quality of our dentistry had better be the very best.
We’re happy to help you with any insurance questions you have. We’ll go over your policy with you, try to maximize your benefits, and request a predetermination of benefits to let you know what your insurer will pay. But please remember your insurer dictates your coverage – we don’t.
If you have any problems or questions, please ask our staff. They are well informed and up-to-date. They can be reached by phone at Greenville Office Phone Number 864-271-6705.