Payment Options
We strive to provide our patients with quality periodontal care that fits your budget! For your convenience, we accept Visa, MasterCard, Discover, American Express, and debit cards, as well as offer financing options through CareCredit to help make your treatment more affordable.
*** Northeast Periodontal Associates has OPTED OUT of all Medicare and Medicaid plans ***
Dr. Reidy wants to be able to provide periodontal care for those who need it. She tries to keep fees at a level that fits a budget for most people. Our fees are based upon the skill, time, judgment, professional care, and office environment provided by Dr. Reidy, our hygienist, and office personnel. Our commitment is to provide the best treatment available for each individual patient, regardless of insurance coverage.
There are hundreds of dental insurance plans, and an increasing number of medical plans, which may assist in paying for your treatment. Often insurance companies change policies and guidelines, making it impossible for us to know what each plan offers. We encourage you to bring your insurance information with you, including a copy of your card, your policy number, and the ID by which the insurance identifies you. We also ask that the insurance information you provide to us is current and accurate and that you notify our office of any changes in insurance information.
WHAT WE GENERALLY ASK OF YOU:
We require a $50.00 deposit to reserve your consultation appointment with Dr Reidy. This deposit will be applied to your consult fee at the time of your appointment. For all extensive procedures (i.e. oral surgery, deep scaling and root planning, implants, ect…) we require a 5% deposit for any planned services at the time of scheduling treatment.
We require a 48-hour notice of all cancellations. Failure to provide us with adequate notice will forfeit your deposit. We will take into account emergent situations and weather. If you need to reschedule any appointments and provide us with adequate notice, you will not lose your deposit. If you need to cancel your appointment and not reschedule, we will refund you directly, provided enough notice is given.
At the time of surgery, we also ask that you pay 50% of the surgical fee at the time of service. If a pre-determination is on file from your insurance company, then we will adjust that amount accordingly. We will submit a claim to your insurance company for their portion on your behalf.
If you do not have insurance, we ask that you pay your entire treatment fee at the time of service. We participate with Care Credit to provide patients with an option for payment plans. Please feel free to ask the front desk staff for more information on this program.
Pre-determination estimates
For some of the treatments we recommend, we can submit a pre-treatment request to your insurance company, providing supporting documentation (i.e. x-rays, periodontal charting, photographs, and notes from your initial consultation). The company will inform us what payment assistance will be available to you for a particular treatment. Your insurance company may limit their liability for treatment by limiting the number of, or the time span allowed, between particular procedures. There are also limitations placed upon the policyholder based upon a yearly dollar amount available or use and the UCR (Usual, Customary and Reasonable). Please note that receiving a pre-treatment estimate does not guarantee that the payment listed is what will be paid. The reimbursement amount is dependent upon the balance of your annual benefit available at the time the claim is submitted to the insurance company. We will only file a pre-treatment request to your insurance if you request one be sent.
UCR (Usual, Customary, and Reasonable)
As previously discussed, insurance may limit payment by the use of UCR fees. Insurance companies select a UCR for each procedure and the percentage at which each will be reimbursed. This is important because your plan may say that your insurance company may reimburse a particular treatment fee at 80%, but that means 80% of the fee chosen by the insurance company, not 80% of the office fee for that treatment.
Your employer, or yourself if you have a private policy, is responsible for the type of plan for which you can qualify. If the employer wants to offer a plan with lower premiums, the insurance company might lower the UCR to reduce the cost of the premiums to both the employer and the employee. A lower UCR means a higher out-of-pocket portion for the patient.
As you can see, your benefits are decided between your employer and the insurance company or yourself and the insurance company if the plan is a private policy. Often, many needed services are not covered. Our office will try to help you understand your available insurance benefits. Please remember that you are ultimately responsible for all expenses incurred, even if the insurance company does not pay what an original pre-determination indicates would be paid. We urge you to be familiar with your policy and what is covered and any limitations that may exist. You can also review the plan with your employer's Human Resources or Employee Benefits representative.