Pediatric Dentist, Novato, CA

Do I Stay with My Child During the Visit?

Yes! In our office, the door is always open to our parents and guardians. It is our experience that children do best during check-ups and treatment visits when supported by a loving adult.

How are Appointments Scheduled?

Our goal is to schedule appointments at your convenience. From experience we have found that preschool children do better in the morning when they are fresher and we can work more slowly with them. School children needing a lot of treatment should be seen in the morning for the same reason. Dental appointments are an excused absence. Missing school can be kept to a minimum with regular preventive care.

Since appointed times are reserved exclusively for your child, we ask that you please notify our office 48 hours in advance if you need to reschedule. That way we can accommodate another patient who needs our care. With the requested notifications, there will be no charge for rescheduling.

A Word About Financial Arrangements

Payment for professional services is due at the time dental treatment is provided. Every effort will be made to provide a treatment plan which fits your timetable and budget, and gives your child the best possible care. Written treatment estimates will be provided for extensive treatment plans. We are happy to receive payment by cash or check. It is customary for parents who bring the child in to pay for the visit.

For Our Patients With Employer Provided Benefits

Please note that your dental insurance benefits are provided by your employer. They represent a contract between you, the insurance carrier, and your employer. As a courtesy, we will file your claim for you, but the understanding is that you are ultimately responsible for the charges from that date of service. We accept PPO dental plans only (those which allow you to choose your own dentist.)

We will try our best to help you through the maze of covered vs. not covered benefits, deductibles and co-payments, and usual and customary fees. As a matter of fact, we will attempt to estimate the patient portion (that percentage not covered by the insurance). That portion is due in full by the end of the treatment appointments. In the event of a balance due after the insurance payment, your account will be billed with payment requested upon receipt.

A Primer On Dental Insurance

Fact 1 - NO INSURANCE PAYS 100% OF ALL PROCEDURES
Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 90%-100% of all dental fees. This is not true! Most plans only pay between 50%-80% of the average total fee. Some pay more, some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage, or the type of contract your employer has set up with the insurance company.

Fact 2 - BENEFITS ARE NOT DETERMINED BY OUR OFFICE
You may have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist's actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist's fee has exceeded the usual, customary, or reasonable fee ("UCR") used by the company.

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable, or well above what most dentists in the area charge for a certain service. This can be very misleading and simply is not accurate.

Insurance companies set their own schedules, and each company uses a different set of fees they consider allowable. These allowable fees may vary widely, because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a level they call the "allowable" UCR Fee. Frequently, this data can be three to five years old and these "allowable" fees are set by the insurance company so they can make a net 20%-30% profit.

Unfortunately, insurance companies imply that your dentist is "overcharging", rather than say that they are "underpaying", or that their benefits are low. In general, the less expensive insurance policy will use a lower usual, customary, or reasonable (UCR) figure.

Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED
When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary (UCR) fee, we can figure out what benefits will be paid. First a deductible (paid by you), on average $50, is subtracted, leaving $100.00. The plan then pays 80% for this particular procedure. The insurance company will then pay 80% of $100.00, or $80.00. Out of a $150.00 fee they will pay an estimated $80.00 leaving a remaining portion of $70.00 (to be paid by the patient). Of course, if the UCR is less than $150.00 or your plan pays only at 50% then the insurance benefits will also be significantly less.

Please keep us informed of any insurance policy changes.

Copyright © 2008 ~ J. Brian Putman, D.D.S. ~ All Rights Reserved.
Pediatric Dentist serving infants, children and teens in Novato, CA and the surrounding areas.
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