Will you verify my orthodontic benefits at my initial consultation?
Yes. We will contact your insurance company to verify orthodontic benefits prior to your consultation. This will enable our financial coordinator to provide you with a financial estimate of any orthodontic treatment.
Although not required, some patients prefer to have us submit a pre-treatment estimate which is a request submitted by us at your consultation to your insurance company requesting benefits in writing. A pre-treatment estimate may avoid confusion if you are covered by more than one dental policy or have any concerns of complete payment of your benefits. Typically a pre-treatment estimate takes the insurance company 3-4 weeks from your initial consultation to complete.
What do we need from you to file your insurance claims?
We will need the insured person’s name, contact information, birth date, social security number/subscriber ID number and group number. We will also need the insurance company phone number and claims address.
How will my insurance company make its payment?
Most insurance companies make initial payments, followed by monthly or quarterly installments over the course of treatment. Payments are made directly to Theresa Shaver Orthodontics, P.C. We will work with your individual carrier to determine specific payment structure.
What if my child is covered by two dental insurance policies?
The subscriber’s date of birth determines which policy is considered primary and which is secondary. Depending on the Coordination of Benefits requirements specific to each plan, full orthodontic benefits may not be available from the secondary carrier due to the “orthodontic lifetime benefit” clause. We recommend you allow us to submit a Pre-Treatment estimate on your behalf to verify in writing the benefit(s) available on each policy. A Pre-Treatment estimate typically takes 3-4 weeks to receive a final benefit analysis in writing.
What happens if my employer changes insurance companies?
All insurance companies have a time limit on filing claims so it is very important you contact our office as soon as possible. You will need to provide us with the new insurance company’s name, address, phone number and eligibility start date so we can file a Work In Progress claim. Depending on the new insurance company’s benefit plan, full orthodontic benefits may not be available for Work In Progress claims. Any remaining balance not paid by your insurance company will be your responsibility to pay.
What happens if I lose my insurance coverage?
Contact us immediately. You will be responsible for your remaining insurance balance however we are more than happy to incorporate the additional balance into your current monthly payment plan based on the number of months remaining in treatment.
What happens if I change jobs and get insurance from a different carrier?
Contact us immediately. We will work with your new insurance company to determine if any orthodontic benefits will be paid since orthodontic treatment is in progress. Please be aware that depending on your insurance company benefit plan regulations, full orthodontic benefits may not be available for Work In Progress claims. Any balance not paid by your insurance company will be your responsibility to pay.
What if I receive an insurance check at home that really belongs to Theresa Shaver Orthodontics, P.C.?
Just bring the check to our office and endorse it over to us.