Office Policies

Insurance

Please bring your current insurance card and photo ID with you to your appointment. We will collect this information during your appointment so we can file a claim to your insurance on your behalf. Please understand that we file dental insurance claims as a courtesy to our patients, so it is important that we get all of the information that we need. We ask that you be familiar with your insurance benefits, because we will collect the estimated amount that your insurance is not expected to pay from you at the time of your appointment.

We file all patient insurance claims electronically to ensure fast and accurate processing. Your insurance company will have your claim and start processing the claim within days of your appointment. By law, your insurance company is required to pay their portion of your claim within 30 days of receipt. You are responsible for any balance on your account after 30 days, regardless of whether or not your insurance company has paid the claim. If you have not paid your balance within 60 days of your appointment date, a finance charge will be added to your account every 30 days until the balance has been paid. Once we receive your insurance company’s payment, if there is a credit, we will send you a refund.

Veranda Dental does not have a contract or partnership with your insurance company. Only you do. We cannot help you with what types of benefits your insurance plan covers, nor are we responsible for how or how timely your insurance company handles your claims. Veranda Dental is not responsible for any errors on the claim. We will only assist you with the estimated amount that you owe us for services, but we will not guarantee what your insurance company will or will not cover. Please be familiar with your dental insurance benefits.

No insurance pays 100% on all procedures. It is meant as an aid to help with the cost of your dental visit. Most insurance companies pay 50%-80% of the average total fee. Some companies pay more, some pay less. The amount or percentage of visit costs that your insurance company pays is determined by the type of plan you or your employer has chosen. We do not determine your benefits.

You may notice that sometimes your dental insurance carrier pays at a lower rate than the dentist’s actual fee. This is called UCR (Usual, Customary, or Reasonable fee). Insurance companies set their own fee schedules and they each use a different set of fees they consider allowable. These fees are determined from the claims it processes and may vary widely. This data is taken and the insurance company arbitrarily chooses a level they call the “allowable” UCR fee. Frequently this data can be 3-5 years old and these “allowable” fees are set by the insurance company so they can make a net 20%-30% profit.

This does not mean that your dentist is overcharging. Unfortunately, insurance companies imply that your dentist is “overcharging” rather than saying they are “underpaying” or that your benefits are low. In general, the less expensive insurance policy will use a lower usual, customary or reasonable (UCR) figure. So while you may pay low insurance costs to have a plan, you will (usually) end up paying more to your healthcare providers because your carrier’s UCR figure is low. You are responsible for any difference between your insurance provider’s UCR fee and your dentists fees.

One last note:

When estimating dental benefits, deductibles and percentages must be considered. Remember, your portion estimated is just an estimate. Your insurance company decides these percentages and sometimes they may differ from what we (Veranda Dental) have figured.

 

Veranda Dental complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.