About Dental Insurance Coverage

                           I. The Definition of "Covered"

Being  "covered", does not mean the insurance will pay for the
service.

Being covered means a procedure is on your insurance's list of procedures which are at a fee that is
less than the office's normal  fees.  The fees are determined by the insurance, not the office.

                                               

                                           II. Insurance Payment Policies

Payment policies are at the discretion of your insurance.

Methods:

1) "Co-Pay".  This is where both you and the insurance pay the fee.  The benefit:  
          a) You receive the procedure at the insurance's reduced fee
          b)Your insurance pays a portion of the fee on your behalf, further lowering the fee.

2) Covered but not paid for:  This is where the fee is reduced, but you pay the entire fee.

3)  Beyond x-rays, exams, and basic cleanings insurance  never pays 100% of your  fees.  There is
always some measure of payment.

4) Predeterminations:  Prior to starting treatment, patients can get an approximation of how much
their insurance will pay for their treatment.  A predetermination is not a guarantee of payment.  It is
the maximum amount your insurance would consider paying for your services. Insurance can still
decide to pay less than what they indicate in a predetermination after further review of a claim.  






                                          III.  Other Basic Factors:  

            The insurance company works on your behalf.
           - Whether you pay for their services directly or indirectly, they work for you.
           - When insurance makes a payment they do it on your behalf
           -An office receives no special benefit participating with an insurance company.
           -In participating with your insurance, the office is providing its services for less.

             Insurances limit the amount they will pay for each year.  This is called an allowance.
             -Once insurance has reached that limit, all fees are paid by the subscriber.

            If your insurance doesn't pay for the service, it is due by you.  
              -Any payment matters should be addressed to your insurance company, not the office.  

            Insurance can reverse its decisions on payments.

           Elective treatment is not subject to reduced fees
           -Your insurance assists you for necessary treatment
           -Treatment such as cosmetic dentistry or whitening is considered elective

             The office follows the standards of the profession,
           -  An office does not work at the dictation of the insurance company.
           - Corners are not cut because of insurance considerations.
Dental Insurance
Contemporary and Laser Dentistry
502 Franklin Ave.
Nutley, N.J. 07110
(973)-661-5050