Pediatric Dentist in Phoenix and Mesa, AZ - Dr. Amy E. Ash and Dr. Randall K. Lout

Office Policies - Pediatric Dentist in Phoenix and Mesa, AZ 

How are Appointments Scheduled?
Do I Stay with My Child During the Visit?
What About Finances?
Our Office Policy Regarding Dental Insurance

How are Appointments Scheduled

The office attempts to schedule appointments at your convenience and when time is available.  Preschool children should be seen in the morning because they are fresher and we can work more slowly with the child for their comfort.  School children with a lot of work to be done should be seen in the morning for the same reason.  Dental appointments are an excused absence.  Missing school can be kept to a minimum when regular dental care is continued.

Do I Stay with My Child During the Visit? 

Parents are invited back during the initial exam and at re-care appointments.  This allows our doctors to discuss their findings and any treatment that may be necessary.  During treatment appointments, one parent is allowed to accompany their child.  We ask that you remain a “silent observer” so that our doctors and staff are able to effectively communicate with your child.  Research has shown that children over the age of 3 react more positively when permitted to experience the dental visit on their own and in an environment designed for children. As your child matures, we hope they will feel comfortable coming back by themselves. This helps to better establish your child’s trust and independence.

What About Finances?

Payment for professional services are due at the time dental treatment is provided.  Every effort will be made to provide a treatment plan which fits your timetable and budget, and gives your child the best possible care.  We accept cash, Visa, MasterCard and American Express.

Our Office Policy Regarding Dental Insurance?

Our office is happy to file insurance as a courtesy to our patients, but the contractual obligation is between you, the responsible party, and the insurance carrier.  We are contracted providers with Delta Dental Premiere, Aetna PPO, Assurant PPO, Humana PPO, Principal PPO, Phoenix Health Plan, Mercy Care, BCBS and APIPA.  We will collect from you the estimated amount insurance is not expected to pay on the date of service.  We do not accept secondary insurance as a form of payment due to the numerous limitations placed on the individual policies.  However, if your secondary insurance is one of our contracted insurance plans we will file and coordinate the secondary insurance benefit as a courtesy.  By law your insurance company is required to pay each claim within 30 days of receipt.  We file all insurance claims electronically so your insurance company will receive each claim within days of the treatment.  Any unpaid claims over 75 days become your financial responsibility.

We are not responsible for how your insurance company handles its claims or for what benefits they pay on a claim. We can only assist you in estimating your portion of the cost of treatment, we at no time guarantee what your insurance will or will not do with each claim. We also can not be responsible for any errors in filing your insurance, once again we file claims as a courtesy to you.

Fact 1 - NO INSURANCE PAYS 100% OF ALL PROCEDURES
Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 90%-100% of all dental fees. This is not true! Most plans only pay between 50%-80% of the average total fee. Some pay more, some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage or the type of contract your employer has set up with the insurance company.

Fact 2 - BENEFITS ARE NOT DETERMINED BY OUR OFFICE
You may have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist's actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist's fee has exceeded the usual, customary, or reasonable fee ("UCR") used by the company.

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable or well above what most dentists in the area charge for a certain service. This can be very misleading and simply is not accurate.

Insurance companies set their own schedules and each company uses a different set of fees they consider allowable. These allowable fees may vary widely because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a level they call the "allowable" UCR Fee. Frequently this data can be three to five years old and these "allowable" fees are set by the insurance company so they can make a net 20%-30% profit.

Unfortunately, insurance companies imply that your dentist is "overcharging" rather than say that they are "underpaying" or that their benefits are low. In general, the less expensive insurance policy will use a lower usual, customary, or reasonable (UCR) figure.

Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED
When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary (UCR) fee, we can figure out what benefits will be paid. First a deductible (paid by you), on average $50, is subtracted, leaving $100.00. The plan then pays 80% for this particular procedure. The insurance company will then pay 80% of $100.00, or $80.00. Out of a $150.00 fee they will pay an estimated $80.00 leaving a remaining portion of $70.00 (to be paid by the patient). Of course, if the UCR is less than $150.00 or your plan pays only at 50% then the insurance benefits will also be significantly less.

MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.

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Pediatric Dentist in Phoenix and Mesa, AZ - Dr. Amy E. Ash and Dr. Randall K. Lout