PEDIATRIC DENTIST
●
1 PARKER AVE, SAN FRANCISCO CA, 94118
● PH: 415-668-3500
BOARD CERTIFIED PEDIATRIC DENTISTS
APPOINTMENT INFORMATION
Thank you for choosing us as your child’s dental health care provider. We are committed to your child’s treatment being successful. Please understand that payment of your bill is considered part of the treatment.
Our Financial Policy:
- Full payment is due at the time of service.
- The adult accompanying a patient and the parents (or legal guardians) are responsible for full payment. In cases of shared custody, the parent who brings the child to the appointment is responsible for payment.
- We accept cash, checks, Visa/Mastercard/Discover Card/Debit Card.
- We offer an extended payment plan with credit approval.
Regarding Dental Insurance:
Our office is a Delta Dental Insurance Premier Plan provider. We also accept dental plans that allow you to choose your own dentist.
For Delta Dental Insurance Premier Plan, we accept assignment of insurance benefits for your child’s visit. However, we do require full payment of the deductible and/or your estimated co-payment at the time of each service. The balance is your responsibility whether your insurance company pays or not. We cannot bill your insurance company unless you give us your full insurance information (name, subscriber ID number/social security number, group number, employer, and insurance carrier name.)
For your convenience and as a courtesy, our office will submit an electronic claim to your dental insurance carrier on your behalf. Please be sure to bring all your insurance information with you and inform us of any changes. Please know that we cannot bill your insurance company unless you give us your full current insurance information.
If your family has dental insurance other than Delta Dental Premier Plan, we will collect payment in full at the time of your visit. We will then provide a statement of services for you and as a courtesy we will submit electronic claim to your dental carrier for you to receive reimbursement. Please confirm with your insurer that you do not have an HMO plan which would require you to see a dentist on a list. We are not contracted with any HMO programs as we do not contract with plans that require us to discount our dentistry in order to appear on their advertising lists. Instead, we choose to take the time to listen to our patients, provide safe and comfortable care, use the finest labs and highest quality dental materials, and adhere to the strictest infection control standards. Most plans, with the exception of HMO plans, allow patients to choose their own dentist and the level of dental care that best meets their needs.
Please understand that your insurance policy is a contract between you and your insurance company. Reimbursement levels are dependent upon the premiums you pay and the benefits that your employer negotiates. We are not a party to the contract. As such, we can make no guarantee of estimated coverage or payment. Also, plan benefits from the same insurance carrier can often differ significantly by employer. If you would like to know how your plan will work in our office, please call us and we will contact your dental plan to find out the details for you before your child’s upcoming appointment. Please know that we will do everything possible to see that you receive the full benefits of your policy.
Most insurance companies take one to three weeks to process and return payment. If a credit balance results on your account, a refund will be sent to you.
In the event that we do accept assignment of benefits and your insurance company has not paid within 45 days, you will be responsible for the total amount of your balance. A service charge of 1.5% per month will be assessed for accounts past due. Please be aware that some, and perhaps all of the services provided may be non-covered and not considered reasonable and necessary by your insurance company.
To expedite your claims, please notify our office if you have any insurance changes prior to your next appointment.
We know that dealing with insurance carriers can sometimes be a frustrating and confusing process. We are here to use our expertise to do everything in our power to make sure you receive every benefit to which you are entitled and to help you understand your policy benefits. If you ever have any questions, issues or concerns, just ask and we’ll do whatever we can to be of assistance.
Usual and Customary fees:
Our office is committed to providing the best possible dental and oral health care for our patients and we charge what is usual and customary for our area. You are responsible for payment regardless of any insurance company’s determination of “usual and customary fees.”
