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As a service to our patients, our dental practice accepts most dental insurance programs, including non-managed care, indemnity (traditional) and PPO out-of-network. Our PPO dentists are not part of any managed care network, like HMO or DHMO. Regarding PPO dental benefits, our accounting staff will prepare all the necessary forms for those benefits. We remind patients, however, that specific insurance policy is an agreement between the patient and the PPO insurance company. PPO dental insurance helps dental treatments to be more affordable. Some PPO dental insurance benefits include braces. Please keep in mind that you are responsible for your total obligation should your dental PPO insurance benefits result in less coverage than anticipated. Our staff will gladly submit a pre-treatment estimate to your PPO dental insurance company so that you will know what your benefits will be.

Now with the Affordable Care Act, we can do more dentistry with your same insurance plan. For children with extensive work in certain circumstances, we can go beyond your allowance and save you money!

Insurance Providers We Accept (In-Network):

Our office accepts all PPO insurance plans, as well as the following:

Employer Insurances We Accept:

Medical Center and Schools

Retail

The fees charged for services rendered to those who are insured are the usual and customary fees charged to all our patients for similar services. An insurance policy may base its allowances on a fixed fee schedule, which may or may not coincide with our usual fees. Patients should be aware that different insurance companies vary greatly in the types of coverage available. Also, some companies take care of claims promptly while others delay payment for several months.

Please note: We no longer accept DMO or DHMO dental insurance. We encourage you to switch over to your employer’s dental PPO or PDP plan to ensure that we can continue to offer the best dental care for you and your family. Our Houston dentists do, however, accept Medicaid Dental Insurances.

Office Policy

If the patient’s dental insurance information is provided on the day of their visit, our office can file their claim. Since we file claims digitally, the insurance provider will receive the claim in a matter of days. The estimated amount that a patient’s PPO dental insurance does not pay will be collected from the patient, so it is important for them to be familiar with their plan’s benefits. PPO dental insurance companies are legally obligated to pay each claim within 30 days of receiving them. After this period, the patient is responsible to pay the remaining balance.

PLEASE NOTE: Although we file PPO dental insurance claims for our patients, we do not have a contract with any insurance companies. We cannot guarantee if the provider will accept the claim and help cover the costs of treatment. We are only able to estimate how much the patient may owe for their dental care. We cannot be held responsible for issues with filing insurance claims; our staff files these claims as a courtesy to our patients.

Important Facts About Insurance Claims

To help you understand the details of your dental insurance coverage, take a look through the facts provided below. If any changes to your insurance occurs—such as your provider’s name, their address, or you undergo a change employment—please let our office know.

1. No Insurance Pays 100% of All Procedures
Dental insurance plans are designed to help cover the cost of dental care. While every plan covers a different percentage, they usually pay about 50-80% of the total fees—not 90-100% like many people believe. The amount your dental insurance will pay is typically based off of how much you (or your employer) have paid for coverage or the contract between your employer and insurance company.

2. Our Office Does Not Determine Your Benefits
In some cases dental insurance companies may offer reimbursement that is lower than the dentist’s fee. Insurance providers commonly explain that this reduced coverage resulted from the fee being over the usual, customary, or reasonable fee (UCR) they refer to. Unfortunately, this message can be misleading, causing many patients to think that any fee over the amount the insurance company is willing to pay is unreasonable or abnormally high. This is inaccurate.

Every PPO insurance company follows a different schedule and uses a unique set of fees they deem allowable. These fees can greatly vary between providers, since each one collects data on the claims it processes. The companies then use this information to select a level they consider the “allowable” UCR charge. Many times this data is outdated by up to five years, and the allowable charge is set by the company, allowing them to make a net profit of 20-30%.

This message of what insurance companies consider an allowable fee suggests to patients that their dentist is overcharging—when in reality, the company is underpaying—or the benefits of their plan is low. In general, the lower the cost of an insurance policy, the lower the UCR amount will be.

3. Deductibles & Co-Pays Need to Be Considered
When evaluating your dental benefits, remember that deductibles and co-payments are your responsibility. These costs are up to you to pay before your insurance provider begins coverage.

Financial Agreement

Payment for dental services is to be paid in full at the time of service. Signature Smiles accepts cash, check, Mastercard, Visa, American Express, Discover and CareCredit. Returned checks are subject to a processing fee as determined by the bank and the office. PLEASE BE AWARE THAT THE PERSON OR PARENT BRINGING THE PATIENT TO OUR OFFICE AT THE TIME OF SERVICE IS RESPONSIBLE FOR PAYMENT OF ALL CHARGES. If someone other than the parent accompanies the patient, arrangements for payment should be planned in advance.

Online Bill Pay with DOCPAY™

For your convenience, our office accepts online payment through DOCPAY™. This service makes it possible for you to make a one-time or recurring payment to cover the outstanding balance for your dental care. To use DOCPAY, a small processing fee is required. No credit approval is needed. The online system accepts payment from checking accounts as well as credit cards.

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Accepted Patients for Medicaid

Our Houston dental office accepts dental Medicaid for kids only. Medicaid kids can be no older than 20 years old. In some cases, Medicaid covers 100% of the cost for certain treatments. Please understand that there may be exceptions and changes to Medicaid dental insurance coverage.

PLEASE NOTE: Our Medicaid dentists and staff will check the details of your coverage one day prior to your appointment date. In your Medicaid dental insurance registration/policy, your child must also be assigned to our office before your appointment.

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