Helpful Information

Insurance

Our office staff simplifies the dental insurance claim management processes for our patients. So, here are the easy steps and some help information:

1. Call our Royston dental office at 706-245-5031 or email us and reserve your new patient appointment. During your conversation, she’ll gather the information needed from you that is available on your insurance card.
2. To minimize your out-of-pocket cost, we accept most insurances. We are an out-of-network provider and will file on the patient's behalf if they have out-of-network benefits. We do not accept Medicaid or Medicare.
3. Co-payments (which is the patient portion of the fee) varies according to the insurance you have. From the information provided to us by your carrier, we will estimate your benefit and out-of-pocket expenses. And, we practice an easy to follow guideline: “Inform before you perform”. This means that we’ll review anticipated insurance benefits and your portion of the cost before treatment is started. After all, we’d want to know the fee and we believe you would like to, also!
4. After the claim is paid, if a “0” balance is not gained on the account, we either refund an over-estimate or send you a statement for any remaining balance.
5. As a service to our patients, we file claims to your insurance company for you. We can determine your coverage prior to treatment according to the information provided to us from your insurance company. Any outstanding balance after insurance payment has been received is the patient’s responsibility. If we have not received reimbursement from your insurance company within 30 days, we will ask you remit payment for any balance due on the account.

Many patients know they have insurance and have not had the “ins and outs” explained in a helpful manner. We enjoy educating and helping patients and the following explanation may be helpful to you: Dental insurance is structured quite differently than medical insurance. In simple terms, dental insurance is a set amount per year that your employer has agreed to spend to help you with dental costs. Unlike medical insurance that takes care of “everything” after you pay a certain cost, dental benefits are capped typically between $1000 and $2500. Any coverage is helpful, but dental benefits have decreased throughout the years when previously a patient’s common annual needs were readily covered by their insurance plan. However, considering the vast number of patients who come regularly to the dentist with no benefits to offset costs, dental coverage is still a wonderful employer-paid benefit.

We encourage patients to let the state of their oral health and treatment options guide the choices for their well-being and not whether or not your insurance will cover it. When small dental problems are caught and treated early, the lifetime expense to the patient is significantly less and there are many functional and esthetic advantages to treating dental problems when they are small – whether covered by insurance or not! If you are concerned about paying for dentistry, check out our awesome payment plans with Care Credit.

We are often asked if we are on a PPO or discounted insurance plan. After reviewing the fee reimbursement levels, we made the decision that it was not in the best interests of our patients to cut our fees and, consequently, seek ways to reduce the cost of materials, lab and other “corner cutting” options. Here’s a major rub: The ethics and values of dental practices vary as widely as car repair shops. We often meet new patients who have been given treatment plans from other offices that recommended treatment on healthy teeth or recommended treatment on problem teeth that we believed could be treated more conservatively. We encourage all patients to select their dental office carefully and weigh your priorities and values to make the choices best for you and your family.