Policy on Insurance
At Crawford Endodontics we make every effort to provide you with the finest care and convenient financial options. To accomplish this goal, we work hand in hand with you to maximize your insurance reimbursement for covered procedures. 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 515-232-2090. Please call if you have any questions or concerns regarding your initial visit. Please bring your insurance information with you to the consultation so that we can expedite reimbursement.
Drs. Crawford accept Delta Dental Insurance in the Ames office, however, the actual reimbursement by an insurance carrier can vary a great deal. Your reimbursement may not be equal to our fee. Be assured we will do everything we can to make sure you are properly reimbursed by your insurance company. The following few paragraphs explain in detail how discrepancies and misunderstandings can occur.
Dental benefits vary considerably from one plan to the next, the range of benefits depending solely on what the purchaser wishes to offer employees or members. Some plans may cover as little as 30 percent or as much as 100 percent of dental services, with most falling in the 50 to 80 percent range. Some plans exclude certain types of services, i.e., orthodontics, implants, or "bridges" while other plans will cover a full range of dental services.
Some plans base the amount of benefit on a chart or schedule of fees arbitrarily developed by insurance companies. For this reason, you may receive a lower percentage of the reimbursement level indicated in your dental plan. For example, your plan may state that it will pay 80 percent of the fee arbitrarily determined by the insurance company and not 80% of the actual fee charged by us.
If you receive a communication from your insurance carrier suggesting that our fee is over and above the usual and customary rate for the services provided to you, please do not accept this as necessarily fact. The insurance carrier's fee data may be extremely out of date or not take into consideration local factors in establishing its schedule. Our fees are well within the normal range for our area. In fact, our fees are often lower than other practitioners (including some non-specialists) in our referring area. After our discussions, if you believe that the dental benefits provided by your plan are inadequate, you may want to discuss the matter with your employer, union representative or association so that alternatives can be investigated.
If your dental benefit plan requires a "pre-determination" or "prior authorization", we will submit a treatment plan for review by your insurance carrier at no additional cost to you.
Again, we will help you in every way in filing your claims, handling insurance queries, processing follow-ups, lost claims, etc. Call any time you have a question. We are here to help you.