accessibility ACCESSIBILITY

The following is a list of insurance companies that we are providers for and their links.  If you have any questions regarding your dental insurance benefits, please contact your insurance company or our insurance/finance coordinators for more information.

 

Aetna: www.aetna.com

Ameritas: www.amertiasgroup.com

Assurant: www.assuranthealth.com

Blue Cross Blue Shield of North Carolina: www.bcbsnc.com

Cigna: www.cigna.com

Delta Dental of North Carolina: www.deltadentalnc.org

Dental Benefit Providers: www.dbp.com

Guardian: www.guardianlife.com

Lincoln Financial: www.lfg.com

Metlife: www.metlife.com

Third Party Administrators: www.acsbenefitservicesinc.com

Tricare: www.tricare.osd.mil

UMR: www.fhs.umr.com

United Concordia: www.ucci.com

United Healthcare: www.uhc.com

 

Our Dental Insurance Policy

•   If you are covered by a dental insurance plan, please bring an updated insurance card with you at all times as we need to make copies of your card. If your spouse and/or children are covered under your policy, they would need to bring their card as well at each visit. It is your responsibility to inform us of any changes in your insurance carrier or policy as soon as possible. Our treatment coordinators will perform a complimentary benefits verification at or before your first visit with our office or whenever you have a new plan.

•   Dental insurance is a contract between you and your insurance company. It is the insured responsibility for knowing their insurance benefit coverage. We are NOT a party to this contract, in most cases ( i.e. the patient is responsible to the doctor and the insurance company is responsible to the patient.) Professional services are rendered to a person, not to the insurance company. Our treatment is based on the dental needs of the patient, not what the insurance company covers. We cannot render services to a patient on the assumption that the charges will be paid by the insurance company, nor can we know every service not covered by your insurance company.

•   If for whatever reason your insurance company denies your claim. We will do our best to try to appeal the denial only with your involvement. However, we expect payment of the full balance within 15 days of the notice you receive from your insurance company. We will be happy to submit an insurance claim for you as a courtesy. Although we may estimate what your insurance company may pay, it is the insurance company that makes the final determination of your eligibility. You agree to pay any portion of the charges not covered by your insurance. For each date of service, we will file your primary insurance once. After 30 days from the date of service and we have not received payment from your insurance company, you will be required to pay the full balance and seek reimbursement from your insurance company.

•   For extensive procedures, a pre-authorization or pre-estimate (EOB: explanation of benefits) to your insurance may be sent at your or our discretion. It will take at least two weeks to receive an answer back from your insurance. If either party receives it first, then it is each party's responsibility to call one another to discuss the EOB.

HMO/DMO (Health or Dental Maintenance Organization) Policies, please make sure you are assigned to our office as your primary care provider before you schedule your appointments.

Secondary Insurance Policy: If you have a secondary insurance policy, we ask that you pay your co-pays and deductibles from your Primary Insurance Policy first, we will print a claim form and necessary receipts for you to file to your secondary insurance policy for reimbursement.

Insurance Policy “Down-grades”, yearly limitations, and clauses: Some insurance policies may “down-grade” certain procedures such as resins (“tooth-colored fillings”) to amalgams (metal fillings), porcelain crowns to gold crowns, limitations of payments for 2 “cleanings” per year instead of four cleanings or periodontal maintenance, or if you have pre-existing conditions prior to have coverage, the insurance policy may or may not pay all or a portion of your treatments, then you are responsible for differences in the fees (i.e. whatever the insurance will not cover).