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As a courtesy, for those patients who have insurance, we will be happy to file a claim with your carrier. For us to efficiently file your claim, it is your responsibility to bring the policyholders information as well as your insurance company's information.
A common point of confusion is about how the insurance company determines UCR (Usual, Customary and Reasonable). Many carriers determine what they consider UCR by a negotiated list between them and your employer for a given procedure. The payment listing is related to cost of the premiums and the geographical area where the services are rendered, usually separated by zip codes. An insurance company surveys the area, calculates an average fee, takes 80% of that fee and considers it UCR. The most
misconception is that your insurance company will pay 50%, 80% or even 100% of our fee. This is not true and very misleading. In most cases, the payment your insurance company issues is usually much less then the actual billed amount that we charge.
It is our policy to collect 20% of our fee on the day of treatment. Please note that once your insurance company has paid on your claim, you are responsible for any balance that remains on your account. The cost of handling insurance within our office includes repeated phone calls to check status on your claim, resubmitting radiographs because insurance companies state they were lost or never received, excessive paperwork, mailing and redundant billing. The cost of handling insurance is not trivial,
but instead very substantial. Extreme patience is involved for claims that can take 1 to 3 months or even longer to be processed.
In some cases a refund check will be due back to the patient once their carrier has paid our office. Although your insurance company notifies you by mail as to what amount they have paid our office, often the check is not issued for 2-3 weeks after this notice has been printed and sent. Depending on the date, insurance companies typically batch their checks twice per month. A patient should receive a refund check from our office within 5 days after having received payment from their carrier.
We accept Visa, MasterCard and Discover. For those patients with insurance, we are pleased to assist you in completing required forms for your reimbursement after treatment is completed.
Please give at least 24 hours notice of change of appointment if cancellation is absolutely necessary, otherwise a charge may be applied.
Please feel free to ask any additional questions that you may have. We feel that your understanding and cooperation are a most important part of your treatment.
Membership in professional organizations:
American Dental Association
American Association of Endodontics
Chicago Dental Society
Illinois State Dental Society
E.D. Coolidge Study Club
Illinois State Endodontic Society