The cost of treatment and insurance coverage
varies according to the procedures performed, as well as whether the
services are preventive, restorative, orthodontic or cosmetic. Many of
our patients are fortunate to have dental insurance benefits. If you
do, we will help you determine the coverage you have available, process
your insurance claims and wait for and accept payment directly (when
allowable) from your insurance company. We provide professional care to
you and are responsible to you and you are financially responsible to
us for the services rendered. Your insurance contract is between you
and your insurance company and therefore you are ultimately responsible
for payment to Drs. Merle & Zicherman, PC. Our administrative staff
will help in every way possible in filing your claim, maximizing your
benefits and handling insurance questions on your behalf. If you have
any further questions regarding your dental benefits, please contact
your employer or insurance company directly.
Note: Your dental benefits are based upon a
contract made between your employer and an insurance company. Many
people receive notification from their insurance company that dental
fees are "above the usual and customary". An insurance company
determines their reimbursement level by surveying a geographical area,
calculating the average fee, then determines that 80% of the average
fee is customary. Included in this survey are discount dental clinics
and managed care facilities, which have severely reduced dental fees
that bring down the average. Most dentists in private practice
delivering quality dental care will have fees that insurance companies
consider as "higher than usual and customary".
Some Insurance companies do NOT recognize
many routine and especially newer dental services. We recommend
quality, proven procedures that are best for the patient's individual
health situation without regard to a particular insurance company's
coverage.