General and Pediatric Dentist in Lockhart and Luling, TX - Plum Creek Dental Group

Office Policies - General and Pediatric Dentist in Lockhart and Luling, TX - Plum Creek Dental Group

 Payment Policies   /  Facts about Insurance
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Office Hours
Monday through Friday --- 8:00 AM - 5:00 PM


Happy Family - General and Pediatric Dentist in Lockhart and Luling, TX - Plum Creek Dental Group

Payment Policies

Payment is requested at each office visit.  If you have dental insurance, as a courtesy we will file your insurance for you.  We work with almost all traditional plans (a plan that allows you to choose any dentist) and several PPO and PDP plans.  We accept Visa, MasterCard, American Express, Discover, personal checks, or cash.  You can also pay for your treatment through Care Credit or Dental Fee Plan, third party finance companies.

We will file your insurance at no charge and we will make every effort to assure you receive maximum benefits.  In order to provide this service, we will need your updated insurance information before each appointment.

Please do not hesitate to ask questions about our financial policy.  We want you to be comfortable in dealing with these matters.  If you have any questions regarding your insurance, we ask that you contact your company regarding the specifics and details of your plan.

We Accept:
American Express Discover Mastercard Visa Care Credit

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Facts About Insurance

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.

Insurance companies will not release the exact amount they will pay for a procedure until the treatment is completed and the claim is submitted.  They will only state the percentage of their fee schedule that they will cover.

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.  Our fees are within range of other dental offices in the area.

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.

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General and Pediatric Dentists in Lockhart, TX
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