Financial Policy
Your dental and oral surgery needs are important to us, and like most of my colleagues in the Medical Profession wish that we did not have to concern ourselves with finances and payments. However, that is not realistic. In order to help our patients we must be able to pay the lease, buy supplies and equipment, and pay our staffs. In order to be able to do this we have had to set certain policies regarding payment for our services. In the long run, this helps to keep your costs down. Every bad debt, returned check, ignored statement has a price, some of which by necessity has to be passed on in the form of higher fees. Based on past experience and necessity, we have had to adopt the following policies:
Payment will be required in full at the time of service. If you have a dental benefit plan and we are able to confirm your benefits before your treatment appointment, that amount will be reduced by what the benefit plan will cover. If we cannot confirm by phone your eligibility or coverage, the full amount will need to be collected at the time of service. (The card you have is not confirmation of coverage or guarantee of payment). We will submit the claim to your carrier or plan administrator and refund any overpayment to you by mail. Some benefit plans will send payment directly to the member if we are not a participating practice. In these cases, the full amount will be payable at the time service is rendered. Please understand that we depend on the information given to us by the representatives of your benefit plan and cannot guarantee the accuracy of any estimated coverage, although we try our best to get as accurate information as we can at the time we contact them. Please also be aware that the specific benefits/procedures covered by the plan are just that- a list of benefits. The fact that a procedure is not a covered benefit of your plan does not mean that it is not recommended, required, or perhaps the best treatment in any particular case. For example, many benefit plans will typically cover only one panoramic radiograph (panorex) every 3 or 5 years. However, many of our patients- especially those in their early twenties or younger referred for third molar surgery (wisdom teeth) should have a current (< 1 year) Panorex. If the most current Panorex is more than a year old, but less than the frequency specified in your benefit plan, the benefit carrier will not cover the cost.
The exception to this policy of full payment at time of service is in the case of implants where 50% of the implant(s) fee will be payable at the time the implant is placed and the remaining 50% when the implant is uncovered. However, if there will be any lab fees, they must be collected before we can send your case to the lab
We accept personal checks, credit cards and of course cash for payment.
We do require a driver’s license, social security number and a current street address (not a PO Box). If you do not have those or would prefer not to divulge them, we can respect that, but cash or money order payment in full will be required before treatment is rendered.
In the event the patient is a minor, a parent or legal guardian must accompany the patient and be the responsible person on the account. If separated or divorced, the parent accompanying the minor patient will be the responsible party. It will be up to the responsible party to seek reimbursement from the other parent. This practice cannot get involved in separation/divorce disputes.
Dental benefit plans (dental insurance) are a contract between you, the patient, and the plan administrator. Generally these plans allow for a fixed amount of benefits which may be applied to certain procedures as negotiated by you or your employer. We are not a party to these contracts and have no say as to the amount of benefits allowed or to what procedures are or are not covered. If we participate with a plan we have agreed to accept the plans fees as payment for covered procedures. The plan usually covers only a certain percentage of those accepted fees. The remainder is the patient’s responsibility.
If we are not a participating provider with these plans, we will require payment at time of service and we will be happy to submit a claim for our services to your benefit carrier, but follow up and tracking will be the patient’s responsibility. Insurance companies, by law, have 30 days from RECIEPT to process and return the claim. If you have not received an explanation of benefits (EOB) from them within a reasonable amount of time (45 days) you should call them to check on the claim status. If you have two Dental benefit plans, and we do not participate in the primary plan, then we are allowed to charge our full fees even if we do participate with the secondary plan. Payment will be required at time of service. We will submit the claim as above, but since the secondary plan will usually require a copy of the EOB before they will consider payment, and since the primary plan usually will not send the EOB to non participating providers, it will be your responsibility to deliver that EOB to us so that we may submit the secondary claim in your behalf.
For plans in which we do participate, we will track the claim and follow up as necessary. In the event the claim is denied, or covers less than expected, we will send a statement for the balance. If the plan covers more than expected, we will refund the difference.
We do not have in-office payment plans. Payment is expected at time of service or when a statement is sent. We will add a $2.00 processing fee for each statement sent after the first statement. For accounts delinquent after the third statement a finance charge of 1.5% or a $2.00 minimum will be added, monthly to the balance due. If you do need financing, we partner with Capital One Health Care Finance. Capital One will provide financing to qualified patients for dental treatment at no or low interest rates. Qualification can be obtained online or over the phone. We have the details available if you are interested.
We understand that not everyone can afford necessary dental or oral surgery treatment. Dr. Kohler volunteers a portion of his time to treat patients from the Stanton Center in Annapolis and patients referred from the County Health Department. We urge you to investigate those avenues if the cost of treatment would create an undue hardship. Other options would include the University of Maryland or Howard University Dental Schools. Both Universities as well as Washington Hospital Center have Oral Surgery training programs and may offer lower cost treatment.
In the event a personal check is not honored by the bank for any reason, a $35 returned check fee must be assessed to cover our bank costs. The balance must then be paid by cash or credit card. We do not redeposit dishonored checks. Please be aware that “passing a bad check” is a criminal offense in the State of Maryland. We certainly will not pursue this course for anyone who has made a good faith effort to discharge their debt.
We sincerely appreciate your prompt attention to keeping your account current so that we may concentrate on delivery of the quality Oral Surgery care that you deserve.
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