John E. Nathan, DDS, MDS and Associates
Our office is committed to assist you in securing all benefits to which you are entitled from your dental insurance carrier. It is important that you familiarize yourself with the special benefits and limitations of your particular policy. You should be aware that all dental insurance programs vary from one another, some providing greater benefits than others. Levels of coverage can at the very best, be rather confusing. We will make every effort to keep you informed of the specifics of your policy benefits.
Our office participates with several, but not all, insurance carriers and programs. Our office can provide an up to date list of the specific programs in which we participate, and suggest you call us during our office hours. Depending on whether or not our office participates with your specific plan, the following office policies will apply.
For initial visits, payment will be requested at the time services are rendered. Our office will submit claims directly to your carrier at that time. Upon written verification from your insurance company of your participation and coverage, the below policies will apply:
For participating insurance carriers and programs:
Our office will submit initial visit claim forms for you to secure any reimbursements you will be due. To permit us to promptly file your insurance claim, please bring a copy of your insurance card or written verification of coverage to your initial visit. While rare, for some carriers, a formal referral from your primary care dentist may be necessary. Whenever possible, our office will provide you and your carrier with a written pre-estimation for any proposed treatment. Upon receipt of a written response from your carrier identifying specific coverage limits and benefits, you will be asked only to pay what insurance does not cover at the time of service. You will be responsible for any applicable co-payments, deductibles, and amounts not covered at the time services are rendered.
For non-participating insurance carriers and programs:
Regretfully, due to the variable nature of insurance carriers and the levels of reimbursement for different plans, our office is unable to accept or participate with all insurance carriers. If you are in a program for which our office does not participate, and you are still entitled to receive non-participating provider benefits, our office will submit claims for you if you wish. Similarly, our office will provide you and your carrier with a pre-estimation for proposed treatment. Full payment will be required for services at the initial visit, and if a written insurance response to the pre-estimate is received prior to subsequent treatment, you will be expected to only pay differences between actual fees and what your insurance covers. In the absence of a response from your carrier to identify specific benefits, you will be responsible for the full amount at the time services are rendered. For carriers who only provide reimbursement to its participating members, full payment will be required for services at the time they are rendered. Our office is not employed by your insurance carrier, is not subject to its constraints, nor can we serve as a lending institution.
Office Billing Policy
Prompt payment of fees enables our office to maintain fees at the most reasonable levels possible. Under circumstances involving care which is expected to extend over long periods, (i.e. orthodontia), payments may be extended over a mutually agreeable period of time. Such arrangements must be made in advance of the provision of care with the office manager, in writing, finance charges of 1.5% per month will apply for non-orthodontic balances extended over time. A 1.5% per month repeat billing service charge will apply to balances over 30 days past due. A delinquent account or default of payment will be subject to additional collection and attorney fees. A minimum of $25.00 service fee will be assessed for returned checks.
Our office accepts both Visa and Mastercard.