An orthodontist is a dentist who has completed multiple years of specialized training to diagnose and treat dental and facial irregularities in patients. An orthodontist must apply, be accepted and graduate from an institution accredited by the American Dental Association. Throughout their training, the orthodontist learns skills required to manage tooth movement (orthodontic) and guide facial development (orthopedics).
Insurances
Insurance benefits can be complicated, but our billing department is dedicated to helping you navigate your treatment needs and your insurance coverage. Below, you'll find our office's general billing policies as well as answers to our most frequently asked questions.
What are some frequently asked questions during/before ortho treatment?
What insurances do you accept?
Is my insurance in-network?
Network determination can at times be complicated. The days of strictly EPO and PPO are gone. Carriers now offer a variety of networks and sometimes even hybrid options. The list below are the networks our office participates with in umbrella terms. Your network may be titled something different but if it falls under any of these general networks, it should be in-network with our office. We do recommend you call to confirm your network status with either your insurance company or our office.
Natick Dental Partners is in-network with the following carrier's networks
- Altus
- BCBS Indemnity
- Cigna PPO
- Delta Dental Premier
- United Concordia Elite
What does it mean to be out of Network?
Out-of-network means that our office is not directly contracted with your policy. Your policy will be billed and pay as normal but it may result iun higher copays for treatment completed at our office.
What does a standard insurance plan look like?
A Standard plan will have an annual max of somewhere between $1000 and $2000 dollars. Cleaning and preventative treatment will be completely covered. Minor restorative, extractions and root canals have a 20% out of pocket. Major restorative treatment has a 50% out of pocket expense.
There are exceptionally broad figures. Age limitations, frequency limitations, and prequalitying conditions are just a few additional stipulations that insurance companies can add to your policy. Sometimes coverage is tailored to the individual procedure code, of which there are 814 currently. This why we stress that all estimates, are in fact, estimates and coverage can vary greatly from industry standards.
What if I want a definitive copay amount before I start treament?
Unfortunately, insurance companies will never guarantee for a treatment plan. We might suggest a pre-treatment estimate if you have a larger treatment plan, or are out-of-network. This is similar to a claim. We send out your recommended treatment and your insurance will estimate your copay directly. This is an estimate and subject to change. Pre-treatments take roughly 2 to 6 weeks to process and are available for any treatment upon request.
When do I pay?
Our system uses industry standards and averages from over 5000 policies that we have on file to calculate your estimated copay at the time of service. This amount is due when we see you for your appointment. After insurance pays if there is a difference between the estimate and your true copay, you will either be refunded the difference or billed for the remaining amount.
What if my policy changes?
If there is a change in your policy, it is your responsibility to update your insurance policy with our office. Whenever we are able, we will notify you if your policy has terminated roughly one week before your scheduled appointment. We ask that you then update your policy before your appointment so that we can have your new policy details ready for you.
Do you offer payment assistance?
Our office participates with CareCredit. They are a service that provides 0% financing for a certain amount of time depending on the amount you require. Their information can be found here.