On the day of your consultation you were given information regarding the charges for the procedures you will be having done in our office. It is important for you to know what your insurance policy covers. We recommend that you check with your insurance company if you have any questions regarding your benefits. Due to the growing number of insurance companies and plans available, it has become difficult for us to call and verify insurance coverage for every patient. We have found the phone policy of many insurance companies to be that they may only verify general benefit information to the doctors office. They usually cannot quote exact procedure fees, so we are not able to calculate the exact amount that your insurance will pay. You will want to be aware that any information received by phone from an insurance company is not a binding agreement for payment.

We are happy to file your insurance claim forms for you the day of your surgery to assist you in receiving the benefits your insurance company has contracted to provide you.

Key Questions to Ask Your Insurance When Verifying Your Benefits:

1. Yearly policy maximum
2. Benefits used so far in your calendar year
3. Calendar year dates
4. Usual and customary fees foe the procedures you are having done
5. Is general anesthesia a covered benefit for the procedures you are having done?
6. Percent of coverage you are currently at.
7. Verify class code of procedures you are having done (extractions are usually Class ll)
8. If you have two insurances, does your plan have a non-duplication of benefits clause?
9. Age limit for dependent children
10. Student verification requirement

Pre-Determinations

If you or your insurance company requests, we will submit a pre-determination to your dental insurance to help you verify your coverage before surgery.Results from pre-determinations may take anywhere from 3 to 6 weeks depending on your insurance company.

Benefits That May Not Be Covered By Your Insurance:

General anesthesia for extraction of erupted teeth (codes 07110 and 07120), Surgery erupted teeth (code 07210) and residual tooth roots (code 07250).

Having general anesthesia may be in your best interest for the type of surgery you are having, but it may not be a covered benefit by your insurance.

Medical Plans/Networks:

Aetna/US Healthcare, Beech Street Network, Blue Cross HMO/PPO/POS, CCN Network, Choice Care Network, Coventry, First Health, Galaxy, Georgia 1st, Healthstar Network, Humana, One Health Network, Preferred Plan, PHCS Network, Southcare, Unicare

Dental Plans/Networks:

Aetna/US Healthcare, Affordable, American Dental, Ameriplan, Association Dental, Avesis, Blue Cross and Blue Shield, Careington, CIGNA HMO Dental, CIGNA PPO Dental, Compdent, Comprehensive Dental, Countrywide, Delta Dental, Dental Care Management, Dental Directory Services, Dental Health Alliance, Dental Networks of America, Dentemax, Direct Dental Plan, Georgia Dental Plan, GEHA, Guardian, Metlife, Mutually Preferred, National Dental Plan, NHCD, Oral Health Services, Phoenix, Preferred Dental Plan, Protective Dental, Prudential, Signature Dental, Southeast Dental, Spectera, Summitt Dental, Unicare, United Concordia, Wellpoint.

If you do not see your particular plan/network listed, please call our office. Participation with plans are subject to change.