Medical Insurance (In Network) – Medical insurance typically does not cover dental care except for surgery related conditions.  This may included bony impacted wisdom tooth removal, soft tissue biopsy and excision, and certain surgical evaluation and care involving the jaws and maxillofacial areas.  This coverage is dictated by the policy you have with your insurance company through your employer and not determined by our office.  We will contact your insurance carrier and, if you have benefits, file a claim on your behalf.  We will also co-ordinate with your secondary/dental insurance carrier to maximize your benefits in cases involving dental care.  We may provide you with an estimate of the portion of your fees due at the time of service.  Please be aware that all charges are ultimately your responsibility. 

Dental and Medical Insurance (Out of Network) – If our office is outside your insurance company’s network, you are responsible for your fees at the time of service and your insurance company will reimburse you based on your benefits.  We are happy to submit your claim for you.  Benefits are based on the terms of the contract that were negotiated between your employer and your dental/medical insurance company – and are not determined by our office.

Please note: You are responsible for full payment of your treatment cost, whether by yourself, through your insurance company or any other party.  DSPNE is only a third party providing you with the treatment that you need.  As a courtesy, we will file your claim with your insurance company, but we are not responsible for how your insurance will pay for your claim.

 We do our best to determine your actual fees before treatment, based on clinical evaluation during your consultation visit with your doctor, information provided by you before treatment and timely response from your insurance company.  You should receive an Estimate of Benefits (EOB) statement directly from your insurance carrier.  In the event we are not able to contact your insurance company, estimates will be based on our standard office fees.

Additional Costs – Estimates occasionally may be adjusted higher or lower based on the actual service provided by your doctor during treatment.  Common factors that may alter or increase this estimate and your portion due on the date of service may include, but are not limited to: use of nitrous oxide, duration of intravenous sedation, use of materials such as bone graft or barrier membrane, fixture such as implants or abutments, or conditions requiring modification of treatment or procedures based on the exercise of your doctor’s professional judgment.

Thank You!