Insurance
coverage is a contract between you and your insurance company,
and you remain responsible for payment to this office. Our office
will file your insurance claim as a courtesy to you, and we will
attempt to verify all coverage before treatment. If this cannot
be done, payment in full will be requested at the time of treatment.
The term “UCR” is used by insurance companies to determine
the amount that they are willing to pay for a particular procedure,
and this is based on many factors including area of the country
and the specific plan purchased for you by your employer. The administrator
of each dental plan determines the fees that the plan will pay,
and this has no relationship to the fee charged by this a dentist.
Your dental insurance benefit may vary due to:
• Deductible not being met.
• Insurance plan only paid a portion of the fee charged.
Benefits
may have been exceeded for the current year.
Treatment was not covered by your insurance plan.
Ineligible for coverage because your plan has a waiting period.
Your Explanation of Benefits (EOB) will identify co-payment
amount, remaining benefits, and benefits paid. Your insurance
company
is required to pay claims within 15-60 days.
We participate in Delta, Guardian, Aetna, and Cigna dental networks.
Co-payment requested at the time of treatment is based on our
knowledge with previous insurance claims.
We accept Mastercard, Visa, American Express, and Discover.
We offer Care Credit plans for our patients. If you have any
further questions regarding payment, please contact our office
at 817-738-0999 during business hours. Financial arrangements
need to be arranged before your appointment for treatment.

|