Patients who received dental benefits from their employer should consider themselves fortunate. This benefit is like a “voucher” that may reduce the cost of dental treatment. However, no dental benefit plan covers 100 percent of your costs and your particular treatment needs may exceed your calendar year maximum benefits.
Employers offer dental plans based on a contract between their business and an insurance company. Your employer and insurer agree upon the level of insurance coverage you have.
Your dental coverage is not based on what Dr. Noraian recommends or what you need. Your dental coverage is based upon how much you or your employer pays into the insurance plan. For this reason, employers choose to cover some, but not all, of your dental costs. Let your employer know if you are not satisfied with coverage provided by your insurance.
Dr. Noraian‘s Role
Dr. Noraian‘s goal is helping you take good care of your teeth and gums.
Dr. Noraian‘s staff will help you avoid surprises on your dental bill by helping you understand what your insurance does not cover and what you will need to cover. Don’t confuse your dental benefits with your treatment needs, which Dr. Noraian and his staff will help you determine.
Dr. Noraian‘s staff has experience dealing with many different insurance companies. Over the years, each company may offer many different dental and medical plans which may change benefits, co-pays, and deductibles many times throughout the year. Dr. Noraian‘s staff does its best to provide you with accurate coverage estimates based on information available to them. At times, it is almost impossible to accurately estimate a patient’s level of coverage or insurance co-payment. Many insurance companies will not give out fees until after the medical staff completes the treatment. Dealing with these companies can be difficult and time consuming. As a courtesy, Dr. Noraian‘s staff asks that you keep them informed of any changes to your insurance. It is important that all information about you and your insurance is current.
Further, most dental insurance policies are limited and often only pay for a portion of the procedure(s).
Dr. Noraian‘s office prides itself on being able to control your healthcare costs. To continue to offer the latest in proven periodontal and dental implant therapies, Dr. Noraian asks that you pay for treatment in full at the time of service and his staff will submit a claim to your insurance carrier on your behalf with a request to make the payment directly to you. Despite these efforts, insurance carriers may erroneously remit the payment to Dr. Noraian‘s office and they will need to issue you a check to refund the overpayment on your account.
Unless you have made arrangements in advance, Dr. Noraian asks that you pay for treatment at the time of service. Though many dental plans reimburse approximately 30-80 percent of treatment costs it is difficult to determine the exact amount of a co-payment without submitting a pre-estimate. Dr. Noraian‘s goal is to help patients receive treatment in a timely manner, and waiting to hear back from an insurance company may take weeks, thus delaying important treatment. So, to help expedite treatment, Dr. Noraian‘s office accepts cash, personal checks, MasterCard, Visa, Discover, and CareCredit.
If you come to the office with a problem that you expect medical insurance to cover (biopsies, tumors, TMJ, infections), then you must have a referral from your primary care physician. A referral from a dentist is not adequate for medical insurance coverage. Obtaining a medical referral is the patient’s responsibility. Dr. Noraian cannot obtain the referral for you and you cannot obtain a referral retroactively. If you do not have a referral, Dr. Noraian can see you on a cash basis, but your medical insurance company will not pay for your treatment.
Typically, Medicare does not cover dental procedures. If Medicare denies these procedures, you will be responsible for the charges.
Private & Group Insurance
As a courtesy to you when you have medical and/or dental benefit plans, Dr. Noraian‘s staff will gladly file a claim on your behalf electronically including claim forms, receipts, and other information to your insurance company. Of course, you always have the option of submitting the claim yourself. In general, insurers tend to process claims filed directly by patients faster than those filed by the service providers (dental offices).
Upon submitting your claim from Dr. Noraian‘s office, they will request that the insurance company remit the payment to you directly. Despite these efforts, occasionally the insurance company will remit the payment to Dr. Noraian‘s office. If there is a credit on your account the office will refund you.