Insurance Agreement

Thank you for choosing our office to provide you with upscale dentistry with a small town feel. If at anytime you have questions regarding our financial policy or insurance please feel free to ask a business member of the dental team..

Dental Insurance

• Doctor Barroso is an out of network dental provider. An out-of-network provider is not contracted with any health insurance plan. However, our office will file your insurance for you for up to 60 days. After that, the total unpaid balance by your insurance becomes your responsibility.

• Your insurance policy is a contract between you, your employer, and the insurance company. Our office is not part of this contract. Our connection is with you, and not the insurance company.

• Often, an insurance company will use a fee schedule or UCR (usual, customary, and reasonable) fee list. This means that they arbitrarily set their own prices for every dental procedure they cover. This is not based on what a dentist office actually charges, or the cost of the procedure in a geographic region, but what the dental insurance believes we should be charging for a dental procedure. For example, insurance may claim they will cover your cleaning at 100%. The cleaning may cost $85; although, your insurance company will only allow $65 because that is the UCR fee. Leaving you a balance of $20

• Even though we may estimate your insurance benefits based on the information provided by your insurance carrier, it is not our responsibility for the accurateness of the estimate. Knowledge of benefits, the benefit amounts, exclusions, waiting periods, missing tooth clauses, frequencies, etc is your responsibility.
  
  Exclusion: Exclusion is a provision within an insurance policy that eliminates coverage for certain services.

Waiting Periods: A waiting period is the length of time an insurance company will make you wait after you are covered before they will pay for certain procedures.

Missing tooth Clause: missing tooth clause allows the insurance company to not cover the replacement of a tooth that was missing before the policy was in effect.

Frequency: how often an insurance company will pay for a procedure.

• If you are a member of Delta Dental insurance, they do not always allow “assignment of benefits.” Meaning the insurance check goes to the patient and not to the doctor. In this case we will file your insurance for you; however you will be responsible for payment in full when services are rendered.

• Services not paid or covered by your insurance company for any reason are your responsibility, despite the reason for nonpayment. Some of the services that we provide may not be covered by your insurance. Additionally, co-payments and deductibles are due at the time service is rendered.