A: It is a natural instinct to shop around, especially during hard economic times. We always inform our patients and disclose our service fees before we perform any procedures.
There are several scenarios which enable us to provide you with a specific quote:
1. You don’t have dental insurance (fee-for-service patients)
We can provide a quote for a specific procedure, if you answer yes to each of the following questions:
— Have you been to a dentist in the past year?
— Can you provide us with a treatment plan from that dentist?
— Can you provide us with a set of current x-rays? (less than a year old)
Otherwise, a limited/problem-focused ($69) or comprehensive examination ($78) with a set of x-rays ($101) is required to receive a complete treatment plan containing specific fees. Once again, if you have recent x-rays, be sure to bring them to your first appointment, or have us request them from your previous dentist by filling out new patient forms.
2. You have dental insurance coverage
Many factors affect your dental service fee if you have insurance. These include:
- the extent to which your specific plan covers a specific procedure;
- whether the yearly allowable limit or deductible have been reached in the current insurance period;
- example: Another dentist billed your insurance for services earlier this year, using up some of the policy benefits while meeting your deductible.
- whether you have coverage at the time the service will be provided;
- example: It’s important that you have coverage not only today or a week from now, but also next month when we are finishing up your treatment;
- whether Urban Smiles is as a preferred provider for your insurance carrier;
- example: If we are a preferred provider (PPO), we are contractually obligated to follow a pre-set fee schedule for policy subscribers — lower than our standard fees.
- whether you are covered by one or multiple policies;
- example: You may have primary coverage through your work; secondary coverage through your spouses’ employer; and additional continuous coverage under your parents’ insurance if you are under 26.
In other words – If you have dental coverage – it is impossible to answer the question “how much will treatment x cost” without first verifying your individual insurance benefits. All this hard work is being done by our staff behind the scenes during your initial appointment, which, in most cases, is covered by most insurance plans 100%.
3. You have a Health Savings Account (HSA) or Direct Reimbursement plan through your employer
The fees are equivalent to direct fee-for-service patients (see above). Our staff will provide you with all necessary documentation to help you get reimbursed for the services rendered.
It is our goal for patients to clearly understand their treatment options, as well as their financial responsibility before treatment begins.