Dental Insurance
Reimbursement process for patients with braces insurance
Orthodontic and other dental care procedures can be expensive, and even the best dental plans will not cover all of the costs associated with treatment. This can be confusing for some patients. At Ark Esthetics, we want to demystify the confusion so you can know and understand what to expect. Generally speaking, here is how the reimbursement process works:
When a patient calls to schedule an appointment for an evaluation, the office will ask the patient if they are covered under any type of insurance plan. If the patient has dental insurance for braces and other forms of orthodontic treatments, the office coordinator at Ark Esthetics will contact the patient’s provider to determine their individual eligibility of benefits, also known as an EOB. They will also consult with the insurance company so that the cost of with dental insurance with braces can be calculated.
Once the doctor examines the patient, and has recommended a course of treatment, these findings are then communicated to the insurance company. The insurance company will then provide the office and the patient with the amount of the treatment that they will cover on the patient’s behalf. While the insurance provider will usually not cover 100% of the treatment, the cost of braces with insurance should be significantly reduced.
It is important for patients to understand that Ark Esthetics has no contract with the insurance company.
The contract for dental insurance for braces exists solely between the patient and their provider. Our office can make no guarantees about what the insurance company will or will not cover, and no procedure is covered completely. The insurance company will reimburse Ark Esthetics on the patient’s behalf, so the only thing the patient need worry about is paying their portion.
Our staff is more than willing to work with patients and stand ready to explain the steps in the insurance process with them. If the amount of treatment is too high for the patient to pay at once, a payment plan can be negotiated. Typically, a portion of the total bill, about 25% to 35%, will be made as a down payment at the time of the procedure. After this, the remaining amount can be divided into smaller payments and spread out over a period of 12 or even 24 months depending on the balance owed.