Finances and Insurance

Payment for office visits and treatment is expected at the time the service is rendered. Unfortunately, we no longer accept personal checks, business checks, or American Express. If you anticipate a problem paying for services, we ask that you discuss this with us, as we do offer payment plan options through CareCredit.

Families with dental insurance must provide our office with accurate dental insurance information at least 3 business days before their scheduled dental appointment to avoid paying out of pocket. If we have received all of your information before your child's visit, we will gladly file your claim for you.

Dental Insurance

Our goal is to work together to achieve one common goal, and that is for our kids to grow up feeling confident about their smiles. We promise to properly communicate all that is needed to obtain that goal, including our financial and insurance policies.

Families with dental insurance must provide our office with accurate dental insurance information at least 3 business days prior to their scheduled dental appointment, to avoid paying out of pocket. If we have received all of your information prior to your child's visit, we will gladly file your claim for you.

Please understand that we file dental insurance as a courtesy to our patients. We are not responsible for how your insurance company handles claims or for what benefits they pay on a claim. We at no time guarantee that your insurance will pay. We will do our best to provide accurate estimated copays, but it is ultimately your responsibility to be familiar with your dental benefits.

  • In Network: We are in network with MOST major PPO Insurance companies. To verify that we are in agreement with your policy, please contact your insurance company.
  • Out of Network: We will collect payment in full at the time services are rendered and provide you with a detailed receipt that you can use to submit a claim to your insurance. Your insurance company will directly reimburse you for the portion they have agreed to cover in their contract with you/the policy holder. If you have any questions, please contact your insurance carrier for more information on how to self-submit a claim.

Facts about Dental Insurance

Since we strongly feel our patients deserve the best possible dental care we can provide, and to maintain the highest quality of care, we would like to share some facts about dental insurance with you.

  • FACT # 1: NO INSURANCE WILL PAY 100% OF ALL PROCEDURES

Dental insurance is only meant to be an aid in receiving dental care. Most people think that their insurance will pay 100% of every single dental procedure; this is not true! Many routine dental services are not covered by insurance. Most plans only pay between 50% and 80% of the average total fee. Some pay more; some pay less. Unfortunately, the amount your insurance plan will pay is determined by how much you or your employer paid for the plan. Typically, the less you pay for the insurance, the less you’ll receive in insurance benefits.

  • FACT #2: DENTAL INSURANCE COMPANIES ARE UNPREDICTABLE

Insurance companies set their fee schedules that they consider as “allowable” based on old data from 3 to 5 years ago. Because of this, insurance companies imply that your dentist is “overcharging” rather than admitting that they are underpaying or that their benefit fee schedules are very low. Insurance companies will often downgrade a procedure code to pay less. A prime example is when a policy considers the payment of a composite filling but with the fee of a silver amalgam filling. Because we do not believe in putting mercury silver filling in a child’s mouth, we do not agree with this way of downgrading procedure codes. We want to provide the BEST dentistry to our patients; your insurance company only wants cheap dentistry.

  • FACT #3: DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED

When estimating out-of-pocket expenses, your dental benefits, deductibles, percentages, frequencies, and yearly limits must be considered. To illustrate, suppose the fee for a certain service is $150. First, a deductible (paid by the patient) is about $50 on average; this will be subtracted from the original amount, leaving $100. If the plan pays 80% for this particular procedure, the insurance company will then pay 80% of the remaining $100, which would be $80. Therefore, for a procedure that costs $150, the insurance would only be estimated to pay $80, leaving a remaining portion of $70 (to be paid by the patient). If your plan pays only 50% or your deductible is higher, then the insurance benefits will be less.

Contact Palm Beach Children’s Dentistry

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