How are Appointments
Scheduled?
What About Finances?
Dental
Insurance Information
Orthodontic
Insurance & Payments
Contact Us
How are Appointments
Scheduled?
The office attempts to schedule appointments at
your convenience and when time is available. Preschool children
should be seen in the morning because they are fresher and we can
work more slowly with them for their comfort. School children with a
lot of work to be done should be seen in the morning for the same
reason. Dental appointments are an excused absence. Missing school
can be kept to a minimum when regular dental care is continued.
Since appointed times are reserved exclusively for
each patient we ask that you please notify our office 24 hours in
advance of your scheduled appointment time if you are unable to keep
your appointment. Another patient, who needs our care, could be
scheduled if we have sufficient time to notify them. We realize that
unexpected things can happen, but we ask for your assistance in this
regard .
What About Finances?
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. We accept cash, personal
checks, debit cards and all major credit cards.
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Dental Insurance
Our office accepts any insurance plan as long as
it is a Preferred Provider Organization (PPO) plan. However, we are
considered an “Out of Network” provider. Your insurance will still
provide benefits, but will pay at what is usual, customary, or
reasonable (UCR). (Continue reading below for more UCR information). We do not accept
any HMO or DMO policies. If you have an HMO or DMO dental plan,
please contact your insurance company for a list of participating
dentists.
If we have received all of
your insurance information on the day of the appointment, we will be
happy to file your claim for you. You must be familiar with your
insurance benefits, as we will collect from you the estimated amount
insurance is not expected to pay. We file all insurance
electronically, so your insurance company will receive each claim
within days of the treatment. You are responsible for any amount
that insurance does not cover.
PLEASE UNDERSTAND that we file dental insurance as
a courtesy to our patients. We do not have a contract with your
insurance company, only you do. We are not responsible for how your
insurance company handles its claims or for what benefits they pay
on a claim. We can only assist you in estimating your portion of the
cost of treatment. We at no time guarantee what your insurance will
or will not pay on each claim. We also can not be responsible for
any errors in filing your insurance. Once again, we file claims as a
courtesy to you.
BENEFITS
ARE NOT DETERMINED BY OUR OFFICE
Dental insurance is meant to be an aid in
receiving dental care. Many patients think their insurance pays 100%
of all dental fees. This is not true! On average, dental plans pay
100% of preventative services, 80% of basic services, and 50% of
major services, all at what is usual, customary, or reasonable
(“UCR”). Some pay more, some pay less.
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 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 UCR figure.
DEDUCTIBLES
& CO-PAYMENTS MUST BE CONSIDERED
When estimating dental benefits, in addition to
the UCR figure, deductibles and percentages must be considered.
Therefore, if your dental plan says they cover preventative services
at 100%, they mean at 100% of UCR. (Example: If a procedure costs
$100 and the plan’s allowable amount (UCR) is $80, then insurance
will pay 100% of $80 and the remaining $20 would be paid by you).
The percentage paid is 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.
Again, assume the fee for service is $100 and a
$50 deductible will be applied to this type of procedure. Assuming
that the insurance company allows $100 as its usual and customary
(UCR) fee, we can figure out what benefits will be paid. First a
deductible (paid by you), in this case $50, is subtracted, leaving
$50. The plan then pays 80% of $50, or $40. Out of a $100 fee, they
will pay an estimated $40 leaving a remaining portion of $60 to be
paid by you. Of course, if the UCR is less than $100 or your plan
only pays at 50% of the procedure fee, then the insurance benefits
will also be significantly less.
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Orthodontic Insurance & Payments
On average, orthodontic benefits are covered at 50% up to the
orthodontic lifetime maximum. Our office does not accept assignment
of benefits for orthodontics. Therefore, you would be responsible
for paying Dr. Plunk, and we will file the claims to the insurance
company as a courtesy to you. We do allow you to pay
out your orthodontic treatment in fixed monthly payments after an
initial down payment. If you choose to pay for orthodontic treatment
in full, Dr. Plunk does offer a 5% bookkeeping courtesy.
Contact Us
1151 N. Buckner Road, Suite 402
Dallas, TX 75218
Phone: (214) 324-KIDS (5437)
Fax: (214) 324-1190
For General Information:
info@PlunkSmiles.com
For Hygiene/Treatment Questions:
donna@plunksmiles.com
For Insurance, Orthodontic or Scheduling Questions:
molly@plunksmiles.com
Click
HERE for a map to our office.
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