Billing

Billing

We are a fee-for-service practice and payment is expected at the time of service.

After the service, we will assist you in submitting the appropriate forms and codes to your insurance. It may be your dental or medical insurance (for TMD and Sleep Therapy) that reimburses you for our services.

Although we don’t technically participate in any insurances ourselves (so we’re always “out of network”), we work with insurances every day, helping to figure out what is covered and how you can be reimbursed.

We fill out all the forms and documentation you need to be reimbursed and make every effort to assist you in maximizing your insurance coverage.

Labs are billed the same way as a service. You may be reimbursed by your insurance and we’ll help to make that happen.

We also offer payment plans when the treatment is extensive.

Insurance Example

There are no set in stone rules for how insurance will work, but our method is as follows:

  1. Before service, if you prefer, we’ll determine the coverage options and likelihood of reimbursement.
  2. At the time of service, you pay in full for the service.
  3. We fill out all the paperwork and bill your dental insurance, for you to be reimbursed.
  4. If the dental insurance does not cover the full amount, in some cases (like when their is a bite or sleep appliance made) we’ll bill your medical insurance who may reimburse you for the remaining amount.

*Medical Insurance follows a similar process to dental, but differs in that the pre-authorization does not indicate the ultimate payment nor is it a guarantee of payment. Although this makes reimbursements more challenging to predict, over the years we’ve become quite skilled at this process, and do our best to provide an optimal solution.

Why Bill This Way?

In 2002 we decided to become a fee-for-service business because it allowed us to spend more time focused on your dental outcome.

This higher level of dental care includes the freedom to perform what is best for each individual patient. It also means we’re able to equip our office with the newest machines and technology along with the most up-to-date systems and processes.

Not Covered By Insurance

Sleep apparatus’ and referrals to have a Sleep Study done at a Sleep Center have not typically been covered by insurance.

In most HMO Plans, care and services from doctors and other health care providers must be in the plan’s network, and we are not officially part of any insurance networks.

Questions? We’re here to help, call (973) 763-2221