It is our mission to provide you with affordable, high-quality treatment that fits your budget! We offer a variety of payment options to meet your needs.
Our flexible payment options include:
- We accept Visa, Mastercard, American Express and Discover, for monthly EFT payments with Orthobanc.
- Orthobanc offers payment arrangements by which monthly payments are drafted directly from your checking account, savings account, credit card, flexible spending account and or health savings account.
- We thoroughly explain your options, so that we accommodate your needs.
Most orthodontic insurance policies cover up to a specified lifetime maximum at 50% of the total fee set by each insurance company and employer. Before your first appointment, we ask that you become familiar with your benefits so we can provide the most accurate information regarding your out of pocket expenses throughout your treatment.
We file all insurance electronically, so your insurance company will receive each claim within days of the treatment. You are responsible for the entire account balance if for some reason your insurance company does not pay on your claim. You will be expected to pay it in full. Please note that some insurance carriers will not reimburse our office directly. In such instances, you will be responsible for the full cost. Insurance companies will send you the check directly.
PLEASE UNDERSTAND that we file orthodontic insurance as a courtesy to our patients. There is no direct relationship with your insurance company and our office. 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, and we will verify your benefits before treatment whenever possible. If you have any questions, we will be happy to assist you. Please do not hesitate to call.
We participate in some In-Network insurance. At the time of verifying your orthodontic benefits, our office will be able to give you your estimated benefits.
Fact 1 – NO INSURANCE PAYS 100% FOR ORTHODONTICS
Many patients think that their insurance pays 50% of the total orthodontic fees. This is not true! Most plans only pay an average lifetime max of $1000.00 payable at 50% of the total fee. The orthodontic coverage is usually determined by the contract that has been set up with your employer and insurance company.
Fact 2 – BENEFITS ARE NOT DETERMINED BY OUR OFFICE
You may have noticed that sometimes your orthodontic insurance insurer reimburse you or the orthodontist at a lower rate than the orthodontist actual fee. Frequently, insurance companies state that the reimbursement was reduced because your orthodontist 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 the what most orthodontist in the area charge for a certain service. This can be very misleading and simply is not accurate.
Insurance companies set their 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 is processes. The insurance company then takes this data and arbitrarily chooses a level they the “allowable: UCF Fee. Frequently, this data can be three to five years old are from various parts of the country. These “allowable” fees are set by the insurance company so they can make a net 20 – 30% profit.
Fact 3 – DEDUCTIBLES & LIFETIME MAX MUST BE CONSIDERED
When estimating orthodontic benefits, deductibles and lifetime max must be considered. To illustrate, assume that the fee for orthodontics is $5,500.00. The estimated orthodontic benefit is $1,000.00. Some orthodontic insurance plans have a deductible; the office will subtract this amount for the lifetime max when they give a fee sheet for the estimated total cost. The estimated orthodontic insurance will be subtracted from the total cost for the patient portion.
MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company, or change of employment.