Contact Us: 415.397.1400
Financial considerations should not be an obstacle to obtaining important health services. Being sensitive to the fact that people have different needs in fulfilling their financial obligations, we welcome and encourage frank discussion of services and fees before treatment to avoid surprises or misunderstandings. We believe everyone benefits when definite financial arrangements are agreed upon. Therefore, we have prepared this material to acquaint you with our financial policies. Please ask questions so that you feel fully informed.
BASIC POLICIES: You, or the person you designated on your registration form, are financially responsible for the treatment we provide. Unless prior arrangements are made, payment is due in full at the time of service. We accept cash, checks, and credit cards (Visa, MasterCard, American Express, and Discover). There is a $15 fee for checks returned to us by your bank. A late charge of 1.5% per month (18% APR) will be applied to all delinquent accounts. The delinquent payer is responsible for applicable attorney and collection fees.
FOR PATIENTS WITH IN-NETWORK INSURANCE: As a courtesy, we accept Assignment of Benefits and will bill your insurance carrier(s) provided proper information is given to us. Understand that most insurance plans do not pay the entire cost of your care. Several factors affect the level of reimbursement, including treatment exclusions, copayments, deductibles, tables of allowances, schedules of benefits, and/or annual maximums. Participation in an HMO or PPO will also affect the amount paid by your insurance company. Financial obligation for dental treatment is between you and this office and is not dependent upon insurance coverage. If for any reason, your insurance does not pay for services, you are responsible for the amount due.
Many dental plans use the term “usual, customary and reasonable” (UCR) to determine how much they pay. There are no regulations as to how insurance companies determine reimbursement levels, resulting in tremendous fluctuation. The language used in this process is inconsistent among insurance companies and difficult to understand. With hundreds of insurance plans on the market and benefits that vary considerably and continually change, we cannot predict what your level of coverage will be. Dental plans are contractual arrangements between you, or your employer, and the insurance company. Questions regarding your dental plan or problems with a reimbursement level should be directed to your employer, union or insurance company to request the appropriate professional review. If we can be of assistance, we will make every effort to do so.
For patients with in-network insurance, we collect an estimate of your portion then submit the claim to your insurance. If there is a significant delay in payment by your insurance company, we may request a full payment. Once we receive the insurance company’s response (the explanation of benefits or “EOB”), we bill you if there is a balance or send you a refund if the estimate already collected exceeds your portion. If you prefer, we will submit a “pre-determination” to your insurance company for an estimate of coverage and collect the amount indicated as your portion. Insurers generally take five to six weeks to process pre-determinations. If the pre-determination is not received before your surgery, we will collect 50% of the total treatment fee. Note: Pre-determinations are NOT a guarantee of payment. Let us know if you would like a pre-determination submitted for your proposed treatment.
To satisfy balances that remain unpaid after 60 days, we request that you provide us with a credit card. We will first send you statements and reminder letters as well as attempt to contact you by phone. If we do not receive another form of payment, balances that remain open for more than 60 days will be charged against this credit card.
FOR PATIENTS WITH OUT-OF-NETWORK INSURANCE: We will bill your insurance carrier(s) provided proper information is given to us. Your insurance carrier will reimburse you directly for any services billed. Payment for services rendered will be due in full at time of service. Understand that most insurance plans do not pay the entire cost of your care. Several factors affect the level of reimbursement, including treatment exclusions, copayments, deductibles, tables of allowances, schedules of benefits, and/or annual maximums. Participation in an HMO or PPO will also affect the amount paid by your insurance company. The final determination of benefits lies with your insurance carrier. Final reimbursement for services is between you and your insurance carrier.
If you have any questions about your level of reimbursement, please call your insurance carrier. Many dental plans use the term “usual, customary and reasonable” (UCR) to determine how much they pay. There are no regulations as to how insurance companies determine reimbursement levels, resulting in tremendous fluctuation. The language used in this process is inconsistent among insurance companies and difficult to understand. With hundreds of insurance plans on the market and benefits that vary considerably and continually change, we cannot predict what your level of coverage will be. Dental plans are contractual arrangements between you, or your employer, and the insurance company. Questions regarding your dental plan or problems with a reimbursement level should be directed to your employer, union or insurance company to request the appropriate professional review. If we can be of assistance, we will make every effort to do so.
