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DRC Financial Policy

Dr. Carl Leonard and staff are proud to be a team whose primary mission is to deliver the best, most conservative dental and preventative services available. Your long-term optimum dental health is our main objective and in order to assist you with the investment in your dental care, we have outlined our office philosophy and payment policy. Comprehensive restorative, prosthetic, cosmetic, implant and periodontal services can be complex and extensive, and we believe our patient should have a complete understanding of the procedures and fees involved. Our office will inform you of your financial obligations before scheduling any treatment, and if you have any inquiries before treatment is initiated, do not hesitate to ask so all questions are answered. Treatment and recommendations are always based on what is best for the patient. We take pride on our knowledge, ability and decision process through a comprehensive oral examination, treatment planning, and quality of clinical and laboratory materials used which will determine the best and most conservative (if appropriate) treatment for the patient.

We deliver the finest care to our patients and request that payments be made at the time service is rendered unless other arrangement has been made in advance.

Insurance

Our office does not determine benefits. Dentist provides treatment recommendations based on clinical exams and discussion with the patient’s needs and goals. Dental insurances do not do this and often your treatment needs will not match what is a covered benefit from your insurance. Do not mistake something that is not covered as something that is not necessary for your proper or optimum oral health. Your dental plan is a form of compensation provided by your employer. You can usually expect the insurance company to subtract your deductible and reimburse you for a portion of our fees. That portion is determined by the contract between your employer and the insurance company. The higher the premium paid by your employer, the more generous the coverage.

If you have purchased your own dental insurance, you may notice that they have waiting periods for certain kinds of treatment and some plans also have limits on how often they allow for certain treatments. We highly encourage you to be familiar with your insurance plan coverage, benefits and co-payments by contacting them prior to your first visit. Please remember that you are fully responsible for all fees charged by this office regardless of your insurance coverage. Although we are not a party to the contractual agreement with your insurance company, we do want to help you receive the maximum reimbursement to which you are entitled.

If you have insurance coverage, a predetermination can be sent upon request. As a courtesy, we will submit all claims electronically. A down payment is required for all complex or extended treatment, regardless of estimated payment by your insurance company. Balances not covered by insurance are due at the time services are provided. Because all plans vary, even within the same insurance company, we will help you navigate questions and concerns regarding your benefits to the best of our ability.

At all times, you can be confident that we will always provide you with our best services without regard to the limitations imposed by your insurance coverage.

Insurance Reimbursement – Usual and Customary Fee (UCR)

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 general 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 the insurance company sets these “allowable” fees so they can make a net 20%-30% profit.

Unfortunately, insurance companies imply that your general 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.

In Dentistry as opposed to Medicine, the quality of care delivered is not taken into consideration with this approach, as well as the immeasurable and inconsistent level of qualifications from the dentist, laboratory and materials utilized.

Payment Options

Payments for routine services such as examinations, x-rays, impressions and emergency visits are due at the time services are provided. Insurance claims can be filed by the office or your may choose to file your own claim and be reimbursed directly.

Open Account Payment Plan Treatment Fees are divided into two or three equal payments. For those individuals undergoing complex treatment and desiring a more flexible payment plan, the open account plan may be the best choice. This plan allows for three equal payments to be paid out over the duration of active treatment period. The first payment of one-third is due at the time of initial treatment, the second payment is due at the mid-point of treatment, and the third and final payment is due at the time of impression/conclusion of the active treatment. A monthly payment plan is also available with the final payment due at the conclusion of the active treatment. All payment plans are interest-free as a courtesy to our patients. Financial arrangements must be made prior to the first treatment visit.

We accept cash, VISA, MasterCard, American Express, Discover, personal or cashier’s checks, or money orders. If you have any problems or questions, please ask our staff. They are well informed and up-to-date. They can be reached by phone at (847) 673-2455. Please call if you have any questions or concerns regarding your scheduled visit.