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3750 Dacoro Lane | Ste 120 | Castle Rock, CO 80109 | (303) 663 3388
5280 Top Dentist 2009 ~ 2018
Smiling Child
Grinning Toddler

Payment in full is due at the time dental treatment is
provided. We accept cash, personal check, MasterCard,
and Visa debit and credit card payments.

For Patients with Dental Insurance:

Provide us with all your insurance information prior to
your child's appointment, we will try help you estimate
the portion of the fees that your insurance may cover.

Please understand that filing your claims is a
courtesy our office provides to our patients. We
will be happy to help you file your claims with your
insurance company, however, you are responsible
for the entire payment due.

It is important that you keep us informed of any
insurance changes such as policy name, insurance
company address, or a change in employment
.

Fact 1 - NO INSURANCE PAYS 100% OF DENTAL
CARE

Dental care: Many patients believe that their
insurance pays 90%-100% of all dental fees.

In reality, most plans only pay between 50%-80% of
the insurance company's predetermined fee
schedule. Some pay more, some pay less.

Both the fee schedule and the percentage paid is
usually determined by how much you or your
employer has paid for coverage or the type of
company.


Fact 2 - INSURANCE BENEFITS ARE NOT DETERMINED BY OUR OFFICE

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 the your dentist's
fee has exceeded the usual, customary, or reasonable fee ("UCR") used by the insurance 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 misleading and is not accurate.

Insurance company set their own schedules, and each company uses a different set of fee schedule
they consider reasonable. These reasonable fees may vary, 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 fees are set by the insurance company so that they can expense their costs and yet try net a
20-30% profit.

Unfortunately, insurance companies imply that your dentist is overcharging, rather than say they are
underpaying or their benefits are low and or their operational costs are unreasonably high. In general,
the less expensive insurance policy will use a lower reasonable (UCR) amount.



Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED


When estimating dental benefits, deductible and percentages must be considered. To illustrate, assume
a service fee is $150.00. Assuming that the insurance company allows $150.00 as its usual and
customary (UCR) fee, we can figure out what benefits are paid. First, a deductible, assume it to be $50
for our example, 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.  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.)  In the example
above, if the your plan pays only 50% of UCR, then insurance benefits will accordingly be significantly
less.


APPOINTMENT POLICY:

Appointed times are specially reserved for each patient.  If you need to reschedule the
appointment, please notify our office at least 48 hours in advance of the appointment time.
No shows or appointment cancellation within 48 hours of the schedule appointment time will
incur a missed appointment fee of $50 per child.

Unexpected things happen, however, please realize that without a 48 hour notice, an
appointment opportunity is being denied to another child. We appreciate your help in
avoiding wasted opportunity for other patients and the associated time and costs.

© 2008 pediatric denticare, p.c.
Purvi V. Shah
Board Certified Pediatric Dentist