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. Orthodontic insurance is added on to some dental plans as an additional benefit to the member. Having dental insurance does not guarantee that you have orthodontic coverage.

In our office, all insurance is considered a reimbursement to the insured member. Our financial arrangements will be made personally with you; however, your insurance company will reimburse you directly. As a courtesy, we will accept your insurance checks from you if you wish to sign them over to our office. As it is your insurance company, our experience has shown that your benefits can be maximized and expedited if you deal with them directly. We will gladly process initial billings, quarterly billings and periodic notifications of continuing treatment. If there are any problems that your employer or insurance company can’t handle for you, we will be happy to assist you.

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, and may include a yearly deductible. 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 as the treatment is rendered, at a percentage determined by your insurance company.

To determine if you have orthodontic benefits, please do one of the following:

Read the fine print in your benefits booklet.
Call your employer’s benefits department or union representative.
Call your insurance company to verify eligibility.

If you have orthodontic benefits:

Please bring your Dental insurance card to your appointment so we may make a copy of it; be sure that it includes the insurance company’s name, address and phone number.
Please 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.)
The insurance company’s website information is also helpful.

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 orthodontic treatment begins we will notify your insurance company so they will begin paying your benefits to you; you should receive this first payment within 4-6 weeks.
Some insurance companies pay the balance of benefits automatically, but if your insurance company requires notification of continuing orthodontic treatment, our office will bill them as necessary.
Please be sure to let us know if you are not receiving your insurance reimbursement checks so that we may look into it further for you.
Our office will also need to be advised of any changes in insurance coverage throughout treatment.

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Flexible Spending Accounts

Many employers now offer Flexible Spending Accounts (also known as Cafeteria Plans, 125 Plans and Medical Savings Accounts, and Health Savings Accounts). These plans are designed to assist families in paying for out of pocket medical and dental expenses, which includes orthodontic services. Flexible Spending Accounts allow families 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 a flex plan, understanding how it works, and how to take advantage of its benefits for your family’s orthodontic treatment.

To determine if your employer offers a Flexible Spending 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 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, 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 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 flex accounts can be spread over the treatment time, according to how your specific plan allows
Funds may be used for services performed during the plans’ benefit period only, so be sure to plan your treatment starting dates carefully

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 flex plan 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 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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