Financial Policy

During a patient’s exam and consultation process a treatment plan of recommendations will be thoroughly discussed, as well as the financial aspects of treatment. Dr Gianfortune will inform patients (to the best of his knowledge) of all aspects of treatment before he performs services. PAYMENT IS DUE AT THE TIME OF SERVICES unless other financial arrangements have been made before treatment has began. Most insurance plans are accepted and for your convenience we will assist you by processing and filing all insurance claims. Our office will estimate your insurance benefits and based upon standard dental benefits and collect your portion at the time services are rendered. ALL INSURANCE CO-PAYS ARE DUE THE SAME DAY AS SERVICES. Our office will accept assignment of your benefits from your insurance company, which simply means we will wait for payment due per the particular insurance contract. Insurance benefits by law should be received within 30 days, which after a period of 60 days if payment is not received the patient is responsible for all fees. When your insurance has paid a claim or after 60 days if there is a remaining balance you will receive a statement from our office.

We do our best to maximize your insurance benefit and may appeal on your behalf unfavorable decisions.

We understand that for larger treatment plans patients need other options. If treatment requires several visits you can pay half of the balance when the treatment is started and the remaining balance will be due before the final appointment. For your convenience, our office has developed a full range of payment options to choose from in order to make this dentistry affordable for you.

Payment Options:

Cash

Personal Check

Visa

MasterCard

Discover Card

American Express

Assignment of Insurance Benefits  

Understanding Dental Insurance

Indemnity plans

The most common insurance programs are indemnity plans, which are also called UCR programs. UCR stands for "usual, customary, and reasonable." In these plans, you may choose any dentist and pay on a traditional fee-for-service basis. The insurance company, who is paid a monthly premium by your employer, then reimburses you for between 30 and 80 percent of the dentist's fee. You are responsible for the remaining 20 to 70 percent after meeting a pre-determined deductible payment. The amount of the deductible is set in the contract between your employer and the insurance company.

Referring to the program and its fees as "usual, customary, and reasonable" is misleading. Most people assume that insurance companies have gathered statistics and that these statistics are the basis for UCR fees. This is simply not true in many cases. These UCR fees often do not represent local dentists' fees or the available treatment options. They may be, in fact, simply fees that are set by the insurance company. As a result, different insurance companies often have different UCR fees for the same geographic area and for the same group of dentists!

Dr. Gianfortune usually does not know if patients have insurance or not. He will always diagnose and develop a treatment plan with the best treatment that is compatible with the patient's requests. Many times there are several options for patients which will ultimately be their own decision on how we will proceed.

As a convenience to you, our office will submit charges for services rendered to your insurance carrier, but we consider the patient primarily responsible for the account. The service provided by our office amounts to an agreement between the patient and the dentist. The insurance relationship constitutes an agreement between the carrier and the patient. There is a wide variety of dental insurance coverage offered. Various programs cover from as little as 30% to as much as 80-100%. Every dental plan has a provision for limiting dollar disbursement by the insurance company for covered services. The type of services covered and the dollar amount assigned to it are determined by the type of plan purchased by your employer. Feel free to call us if you have any questions regarding your account or changes in you insurance. A simple phone call can prevent any misunderstandings.

We pride ourselves on providing our patients the finest, most beautiful, longest lasting dentistry possible today. Prior to treatment, your options will be discussed, as well as fees, insurance, and financial arrangements. We have developed a full range of payment options to choose from in order to make this dentistry affordable for you. 

Insurance FAQs

Do you accept my insurance? How much will they pay?

We currently accept all private insurance plans (plans that do not require you to select a dentist from a list or require our office to accept reduced fees for services). This means that we work with literally thousands of companies. Due to changes in policies, it is impossible to give you guaranteed quotes of their payments. We can estimate your portions based on past payment histories, but it is only an estimate. If you would like to know exact insurance benefits, we can file a "pre-treatment authorization" with your insurance company. This will delay treatment but will give you the exact out of pocket figures you may require.

I thought I paid my portion but I got a bill ... why?

We base the patient portion of your bill on our most current data but there are many factors that can affect this estimate. There may be a deductible (individual or family). Sometimes you may have seen a specialist for care, which uses up part of your annual benefit. Insurance companies do not notify us of changes to your benefits. They will only notify you. Please let us know of any of these changes.

Insurance did not pay ... now what?

We submit your claims as a courtesy. If your insurance does not pay then it is your responsibility to make payment in full for services performed for you. Insurance is a contract between you and the company. Our office is not part of that contract. Ultimately, you are responsible for all charges incurred in our office.

We welcome you to our family and look forward to helping you get the healthy, beautiful smile you have always wanted. If there is anything we can do to make your visits here more pleasant, please do not hesitate to ask us.