Financial

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Orthodontic Insurance

As orthodontic insurance differs from general dentistry insurance, we hope the following information will help you maximize your benefits. Please be aware that orthodontic insurance is added on to some dental plans as an additional benefit to the member, however, having dental insurance does not guarantee that you have orthodontic coverage.

Dr. Phillips is a Premier Provider for the Oregon Dental Service, Washington Dental Service and Delta Dental insurance networks. Benefits from plans through these companies will come payable directly to our office and will be applied to your account. Insurance other than ODS, WDS and Delta Dental is considered a reimbursement for services rendered and will be sent payable to the subscriber. Benefits you receive may be signed over to Dr. Phillips to be applied to your account. We will process all initial billings, quarterly billings and periodic notifications of continuing treatment for all insurance companies. Should you have any problem receiving your benefits, we will be happy to contact your insurance company and assist in resolving any issues.

Please be aware that insurance benefits can be limited to dependent children (adults exempt), can be subject to a waiting period, may have an age limit for dependent children, may include a yearly deductible, and may limit benefits specified by your plan’s contracted amounts. Also, it is important to know that most insurance plans do not pay the benefit amount in one lump payment at the start of treatment. Most companies spread their payments out as the treatment is rendered, at a percentage determined by your insurance company.

If you have orthodontic benefits, or do not know if you do, please do the following:

Provide us with the insurance company’s information if you have not already done so at your initial appointment; be sure that it includes the insurance company’s name, address and phone number.
Be sure that we have the insured member’s necessary information (social security or ID number, birth date, address and phone numbers, and the employer’s name.)

Provided with the above information, we will be happy to verify your insurance benefits with your insurance company.

To receive your insurance benefits:

On the day that the appliances are placed, we will notify your insurance company that orthodontic treatment has started so they will begin issuing your benefits. The initial payment should be issued within 4-6 weeks. Our office will submit subsequent billings if required by your insurance company.
If benefits are being sent directly to you, please be sure to let us know if you are not receiving your insurance reimbursement checks so that we may look into it for you.
Our office will also need to be advised of any changes in insurance coverage throughout treatment.
Should you gain new insurance coverage once a patient is in treatment, please provide us with the necessary information so we may check on benefits for you. Many insurance companies will allow benefits even if treatment is already in progress.

If you have any further questions, our front office staff will be happy to assist you.

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Flexible Spending and Health Savings Accounts

Many employers now offer Flexible Spending Accounts (also known as Cafeteria or 125 Plans) or Health Savings Accounts. These plans are designed to assist families in paying for out-of-pocket medical and dental expenses including orthodontic services. Employees are allowed to set aside pre-tax dollars to help pay for expenses that are not covered by insurance. While these plans are a wonderful way for families to be able to cover these expenses, they are federally regulated with strict guidelines that must be followed and can vary in their format and requirements. We hope that the following information will assist you in discovering if you have one of these plans, understanding how it works, and how to take advantage of it’s benefits for your family’s orthodontic treatment.

To determine if your employer offers a Flexible Spending or Health Savings Account, please do one of the following:

Read the benefits booklet supplied by your employer
Check with your employer’s Human Resources or Benefits Department

If you have a Flexible Spending or Health Savings Account, please be aware of the following:

Eligibility and enrollment requirements
Know when the enrollment deadline is, and what period of time the plan covers (i.e. January to January, July to July, or indefinitely etc.)
Know the maximum amount per year that your plan allows you to set aside for non-reimbursed health expenses
Know what documentation the plan requires you to submit to receive your funds (i.e. a required form, copy of your contract, receipts, verification of treatment, etc.)
Know how your funds will be disbursed to you (i.e. in one lump sum, quarterly or monthly)
Plan requirements can change from year-to-year, and should be reviewed each new benefit period

When determining what amount to put into your Flexible Spending or Health Savings Account to be used for orthodontic services:

Remember that the plan is for non-reimbursed health expenses, so any insurance benefits that you may receive during the benefit period will be deducted from any charges you plan to pay with the pre-tax dollars
Payments from these accounts can be spread over the treatment time, according to how your specific plan allows
Choose your treatment starting dates carefully so that planned funds will be available to you
Flexible Spending Account funds must be used during the current benefit period, are not allowed to accrue and any leftover funds will revert to your employer
Health Savings Account funds may accrue and do not expire if not used during the benefit year

Appointments scheduled for pre-treatment observation are excellent opportunities to plan ahead for your enrollment period. Please make sure that you make your appointments well in advance of your enrollment deadline so that we may do our best to assist in determining your future orthodontic expenses.

Our experienced administrative staff will be happy to assist you with questions that you may have concerning how the account funds will help you with your orthodontic treatment fee. We are very familiar with many of the rules, requirements to follow, and problems to avoid. Once treatment begins, our staff will provide you with any necessary documentation you may require, such as receipts for payments, copies of financial agreements, and verification of treatment.

Please let our administrative staff know if you have any questions, or how we may assist you in understanding your Flexible Spending or Health Savings Account procedures.

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Accepted Forms of Payment

It is our mission to provide you with affordable, high-quality treatment that fits your budget! We offer a variety of payment options to meet your needs. For your convenience, we accept Visa, MasterCard and American Express.

We offer third party financing through the Springstone Patient Financing as well as in-house financing with flexible monthly or quarterly payment options spread over the course of treatment. In addition, we offer discounts for payment in full at the start of treatment and for multiple family members in treatment. We thoroughly explain your options so that we can accommodate your needs.

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