At Advanced Micro-Endodontics we make every effort to provide you with the finest care and the most convenient financial options. As providers of most dental insurance carriers, we will gladly accept your estimated portion of the treatment fee and bill your dental insurance. There are many factors involved in estimating your insurance reimbursement accurately (see below). Please keep in mind, however, insurance companies routinely indicate that coverage verification does not guarantee payment. In the unlikely event your insurance does not pay the estimated amount, you will be responsible for the remaining balance.
Understanding Your Dental Insurance
A dental insurance plan is a contract between you and an insurance company to pay a portion of your endodontic treatment. These contracts vary widely between different insurance companies. A typical percentage of the amount covered runs somewhere between 20% to 80% of the price charged by your endodontist. If your dental insurance is provided by your employer, then your employer has negotiated your benefits with your insurance carrier.
UCR (Usual, Customary and Reasonable)
Insurance companies use the term "UCR" to describe what they will pay for a particular endodontic treatment. These fees are generally 20%-80% less than what the endodontist charges for a particular treatment. Therefore; on your bill you will see a note that the fee charged by the endodontist is higher than the reimbursement from your insurance company. There is no regulation on how your insurance company determines these reimbursement levels. Some factors that influence the UCR fee are such things as number of endodontist in the region and cost of living.
Your plan purchaser makes the final decision on "maximum levels" of reimbursement through the contract with the insurance company. Your annual maximum may be unknowingly exceeded or nearly exceeded when we provide an estimate of your endodontic treatment.
Our Bottom Line on Insurance
We will assist you to the best of our ability in obtaining the maximum benefits from your insurance. We will only recommend treatment according to what is best for you, not according to your insurance benefits.
If you have any problems or questions, please ask our staff. They are well informed and up-to-date.