Financial & Insurance

s-pediatric3We are participating providers with the following dental insurances:

  • Aetna
  • Cigna
  • Delta Dental Premier
  • MetLife
  • United Concordia PPO

** Please contact your dental insurance company to ensure we are an in-network provider. If we are not a participating provider with your dental insurance, we will be happy to assist you in filing your claim given we have all of your insurance information necessary for filing, and we are able to verify eligibility **

Dr. Hamlin and Dr. Morgan are dedicated to your children’s dental health providing the most engaging staff, highest quality of materials and most comprehensive treatment. We have had a great relationship with the military and have supported their families for over 35 years. We have decided to "NOT" participate with United Concordia for Active Duty Dependents. We "CAN" still treat you and your family but it will be out of network. We will continue to submit your claims for you. We are "OFFERING" a Military Discount when your estimated copay is paid in full at the time of service.

Should you choose not to stay with our practice, here are a few questions you should ask your next prospective office:

  1. Are you "IN NETWORK " with United Concordia?
  2. Do you offer a Military Discount?
  3. If you are not in network, do you still file my dental claim for me?
  4. How soon is your next available appointment?
  5. Can you give me an estimate over the phone?

Dr. Hamlin and Dr. Morgan cannot thank you enough for your continued support and for the confidence you have placed in our office.

What About Payments?

Payment for professional services is due at the time dental treatment is provided. Every effort will be made to provide a treatment plan which fits your timetable and budget, and gives your child the best possible care. We accept cash, personal checks, and all major credit cards.

Our Office Policy Regarding Dental Insurance

If we have received all of your insurance information prior to or on the day of the appointment, we will be happy to file your claim for you. You must be familiar with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay. By law your insurance company is required to pay each claim within 30 days of receipt. We file most insurances electronically, so your insurance company will receive each claim within days of the treatment. You are responsible for any balance on your account after 30 days, whether insurance has paid or not.

PLEASE UNDERSTAND that filing your claims is a courtesy our office provides to our patients; it does not guarantee payment to us. We do not have a contract with your insurance company; only you do. We are not responsible for how your insurance company handles its claims or what benefits they pay on a claim. We can only assist you in estimating your portion of the cost of treatment. We at no time guarantee what your insurance will or will not do with each claim. We also cannot be responsible for any errors in filing your insurance. Remember, we are providing our professional services to your children - NOT the insurance company! Consequently, you are ultimately responsible for payment of our fees.Your Dental Insurance Contract is arranged between you and your insurer and it is their responsibility to care for the people and the families they insure. This contract is not made in conjunction with this office. Please be assured that we will make every effort to make filing these claims as simple as possible for you. Once again, we file claims as a courtesy to you.

FACT 1 - NO INSURANCE PAYS 100% OF ALL PROCEDURES

Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 90%-100% of all dental fees. This is not true! Most plans only pay between 50%-80% of the average total fee. Some pay more; some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage, or the type of contract your employer has set up with the insurance company.

FACT 2 - BENEFITS ARE NOT DETERMINED BY OUR OFFICE

You may have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist's actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist's fee has exceeded the usual, customary, or reasonable fee ("UCR") used by the company.

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable, or well above what most dentists in the area charge for a certain service. This can be very misleading and simply is not accurate.

Insurance companies set their own schedules, and each company uses a different set of fees they consider allowable. These allowable fees may vary widely, because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a level they call the "allowable" UCR fee. Frequently, this data can be three to five years old and these "allowable" fees are set by the insurance company so they can make a net 20%-30% profit.

Unfortunately, insurance companies imply that your dentist is "overcharging," rather than say that they are "underpaying," or that their benefits are low. In general, the less expensive insurance policy will use a lower usual, customary, or reasonable (UCR) figure.

FACT 3 - DEDUCTIBLES & COPAYMENTS MUST BE CONSIDERED

When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary (UCR) fee, we can figure out what benefits will be paid. First a deductible (paid by you), on average $50, is subtracted, leaving $100.00. The plan then pays 80% for this particular procedure. The insurance company will then pay 80% of $100.00, or $80.00. Out of a $150.00 fee they will pay an estimated $80.00 leaving a remaining portion of $70.00 (to be paid by the patient). Of course, if the UCR is less than $150.00 or your plan pays only at 50% then the insurance benefits will also be significantly less.

MOST IMPORTANLY, PLEASE KEEP US INFORMED OF ANY INSURANCE CHANGES SUCH AS POLICY NAME, INSURANCE COMPANY ADDRESS, OR A CHANGE OF EMPLOYMENT.

Eastern Virginia Pediatric Dentistry

  • Eastern Virginia Pediatric Dentistry - 1806 Hampton Blvd., Suite A., Norfolk, VA 23517 Phone: (757) 627-7550

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