Insurance & Affordability
Oral wellness is important to the overall health for our patients.
Dr. Aver prides herself on providing quality dental care at an affordable price to all her patients.
It is important for you to provide Dr. Aver’s practice with complete insurance information for all carriers with whom you are insured at the time of care. It is the patient’s responsibility to inform our front office of any changes to your insurance carrier.
As a service to our patients, we will submit your insurance claim to your primary insurance company. Our front office will provide the insurance company with all the information necessary to help you receive maximum benefit from your insurance company. However, it is the patient’s responsibility to know the insurance coverage and benefits limit of their particular policy.
At check out, our front office will collect payment for the patient’s deductible and the estimated balance based on the patient’s primary estimated insurance payment at the time of your appointment. After the primary insurance payment is received, the patient will be billed for any difference between the anticipated insurance payment and the actual insurance payment. If the insurance payment is greater than the estimation, we will either refund the amount to the patient or leave the credit balance on the patient’s account to be applied toward future treatment.
If a claim is denied, we will research why the rejection occurred and either resubmit to insurance or bill you the appropriate balance. If the claim is denied a second time, the appropriate balance immediately becomes the responsibility of the patient and should be paid to us directly. You may contact your insurance company for reimbursement.
** Dr. Aver’s office will submit claims on behalf of our patients to all major PPO dental plans. However, our office is only in-network with Delta Dental Premier.
Dental Insurance: Points to Consider
Irrespective of any dental insurance benefits that might exist, the patient is always legally responsible for the entire cost of dental treatment.
The extent of dental coverage is solely dependent on the dental insurance plan purchased by the employer or patient.
Even if there is a written predetermination of benefits returned from the insurance carrier, it is possible that after treatment is provided, there are no insurance benefits payable.
We (the dental office) have absolutely no power or leverage to deal with the insurance carrier. Only the employee's or the contract purchaser has power. Any complaints about benefits, payment, or coverage should be directed the Human Resources or the company owner.
Just because an insurance code describing a dental service exists, it does not guarantee that it will be a paid benefit under your policy.
Your dental benefits almost always have a yearly maximum contribution level. This amount is the MOST your insurance carrier is contractually obligated to pay during a defined year (calendar or otherwise). When this amount is reached there will be no further dental benefits payable until the next benefit year. If you have already begun some additional dental treatment prior to the maximum being reached, the insurance carrier has no payment obligation beyond that of the annual maximum.
To assist patients with rising dental costs, Dr. Aver has an “in-office” discount dental program available for those who do not have insurance or cannot obtain dental coverage. Our dental program provides a wide scope of benefits at an affordable price. For details, refer to our Dental Discount Program page.