At Pediatric Dental Associates of Glen Mills, we attempt to schedule appointments at your convenience. Preschool aged children usually are seen in the morning because they are more awake and well rested. We also add more time to the morning appointments to allow children “tell show do” time for their visits in order to make them more comfortable. Older children are usually seen in the afternoon to minimize missing school. We try to schedule appointments so that children of the same age groups are seen around the same times. Dental appointments are an excused absence, and missing school can be minimal when regular dental care is scheduled.
Since appointed times are reserved for each patient, we ask that you please notify our office at least 48 hours in advance of your scheduled appointment time if you must cancel. Another patient could be scheduled if we have sufficient time to notify them. We realize that unexpected things happen, but we ask for your assistance in this regard. Cancelations without proper notice may be charged a nominal fee for the broken appointment.
This is always a tough question and answer. We find that many children interact with the dental staff differently when parents are not nearby. Our goal is to make every child feel as comfortable as possible in our office. If you feel that your child needs your assistance and wish to stay with him or her, please let us know and we will happy to accommodate your request. First visits (especially for children under 4 years old) we routinely recommend you accompany your child. After that initial visit, we treat every child on an individual basis regarding these practices. Our goal is to have a comfortable child and parent. Separation anxiety is not uncommon in children, so please try not to be concerned if your child exhibits some negative behavior. This is normal and will soon diminish. We are all specifically trained in helping young children overcome anxiety. Our experience has shown that most children over the age of 3 react more positively when permitted to experience the dental visit on their own and in an environment designed for children.
Payment for dental services is due at the time that treatment is provided. Every effort will be made to provide a treatment plan that gives your child the best possible care, and fits into your timetable and budget. We accept cash, personal checks, debit cards and most major credit cards.
If we have received all of your insurance information on the day of the appointment, we will be happy to file your claim for you. We participate with many of the major insurance companies. Please ask the front desk for details regarding the companies we partner with. You must be familiar with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay. Although we try to collect as much information regarding all our patients plans, it is impossible to know everything. Please be proactive, and contact your insurance company to understand your benefits and copays. We will be happy to help you in this matter. 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 for it or not. If you have not paid your balance within 60 days, a re-billing fee of 1.5% will be added to your account each month until the outstanding balance is paid. We will be glad to send a refund to you if your insurance pays us.
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 do not guarantee what your insurance will or will not do with each claim.
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 - this is not true. Most plans only pay between 50-80% of the average total fee. Some pay more, some pay less. The percentage paid 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 your insurance company.
Sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist's actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist's fee has exceeded the usual, customary, or reasonable fee ("UCR") used by the company.
A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable, or well above what most dentists in the area charge for a certain service. This can be very misleading and is not accurate.
Insurance companies set their own schedules, and each company uses a different set of fees they consider reasonable. These reasonable fees may vary, 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 fees are set by the insurance company so they can net a 20-30% profit.
Unfortunately, insurance companies imply that your dentist is overcharging, rather than say that they are underpaying, or that their benefits are low. In general, the less expensive insurance policy will use a lower reasonable (UCR) figure.
When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume a service fee 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 $50 deductible 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). Of course, if the UCR is less than $150.00, or your plan pays only at 50%, then the insurance benefits will also be significantly less.
MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment. If the proper insurance information is not provided at the time of service and the claim is processed incorrectly due to this, we will reprocess the claim for you but you will responsible to the unpaid claim at that time. The resubmitted claim will be redirected to you personally.