We strive to keep our fees as low as possible for the benefit of everyone. We do not establish our fees on the basis that insurance companies will pay them. Our fees are based on the exceptional skill, time, judgment, professional care, and office environment provided by Farber Center For Periodontics & Dental Implants, Dr. Farber and his staff. We strive to continuously provide the best care available anywhere in the world on a daily basis regardless of insurance involvement. As a benefit to you, we may accept insurance assignment on procedures other than the initial examinations, consultation, emergencies, and periodontal maintenance visits.
insurance may cover all or some of your treament, depending on your policy.
Our insurance coordinator is here to help you in obtaining the full benefits you are entitled to under your dental insurance plan. There are hundreds of dental insurance plans in existence and some of these companies change policies and guidelines weekly. Therefore we encourage you to bring all your insurance benefit information, including your booklet, forms and insurance card to your appointment, and to keep us informed of any change to your insurance.
Before any treatment is rendered we can provide you with a pre-treatment estimate which will include the cost for the procedure. This will be sent to your insurance company and they will let you know what your insurance policy covers. Your insurance company may work to limit their liability through the use of frequency limitations, yearly plan maximums, and their UCR. Please note that a pretreatment estimate is not a guarantee of payment.
Insurance companies may also limit their payment by the use of UCR fees. The insurance companies selects a UCR fee for each procedure and at what percentage the procedure will be reimbursed. For example, a plan with a high premium may have a higher UCR. If a plan has a lower premium the insurance company may set the UCR lower. Your plan booklet may say that they reimburse at 75%, but it is 75% of a number chosen by the insurance company. If an employer wants a plan with lower premiums, then by lowering the UCR, insurance companies can reduce the cost of the premium to the employer. If the UCR is lower this can increase the patient’s out of pocket expenses. (We often see a variety of UCR’s from the same insurance companies for different employers.) If a fee exceeds the UCR chosen by the insurance company, they will tell you “The fee charged exceeds the usual, customary and reasonable fee charged in your area”. This is not necessarily the case, it may be more accurate to say, “The employer chose a plan that does not reimburse at the level charged by most dentists in the area.”
Your benefits are decided between your employer and the insurance company. Many needed services may not be covered. Our office will do everything possible to help you understand and make the most of your dental insurance benefits. Please remember that you are ultimately responsible for all expenses incurred. We urge you to read the policy so that you are fully aware of coverage and any limitations of the benefits provided.
We hope you found this information useful. Insurance matters are often complicated, so if you have any questions regarding your coverage, please feel free to talk to our insurance coordinator.