Family/Cosmetic & Implant Dentistry

Insurance & Financing

payment
WHAT DENTAL INSURANCE DO YOU ACCEPT?  We accept all private and PPO dental plans and are in network with several.  Sorry, we do not take Medicare, Denti-cal or HMO plans.


Professional Woman
Treatment Planning... We understand the importance of being on a budget.  That's why if you need additional treatment... we always work up a treatment plan for you in advance and estimate your patient share before treatment begins.  This way, you're able to make an informed decision and benefit from maximizing your dental plan when available!  

WE MAKE DENTISTRY AFFORDABLE! Ask about our payment plan options!

FINANCIAL POLICY - Payment in full (or patient share if insured) is expected at time of service.  We offer several payment options:

•  Cash/Debit

•  Credit Card - We accept MasterCard,
    Visa, American Express & Discover

•  Payment Plans via 
CareCredit

      Credit Cards
     Care Credit

FINANCING AVAILABLE!  We can make dentistry affordable by offering low monthly payments upon approved credit through our financing partner, CareCredit.  Please feel free to discuss these options with our staff.

"Can you bill me?"  Sorry, but we're not equipped to carry credit for our patients.  However, we can offer affordable payment plans via our finance partner, CareCredit.  Please call us to find out more or click on the CareCredit link above.

                          

QUESTIONS ABOUT YOUR DENTAL PLAN?  Though we make a reasonable effort to assess your plan and answer your questions, most dental plan benefits are set by your employer.  Due to the thousands of employers and dental plans out there, we can not be experts in your coverage and therefore make no promises or guarantees.  HOWEVER, we will do our best to help you... and we can always submit pre-authorizations to your dental plan to know for sure. Otherwise, we suggest you try to familiarize yourself with your plan's benefits and limitations or contact your plan's administrator for specific questions. 

Please feel free to call our staff at 714-668-9811.   We'll be happy to assist you.  

Insurance

HOW 'PPO' DENTAL PLANS
TYPICALLY WORK
There are many variations of dental plans, and most benefits are set by the employer, but typical PPO plans carry the following scenarios:

  • PPO stands for Preferred Provider Option... this type of plan allows you to see any provider of your choice whether they are considered in-network or not. 
  • ANNUAL MAXIMUM- Yearly maximums range from $500-$5,000.  This the total amount your dental plan will pay during a 12 month period.  Your plan may cover only a percentage of each treatment up to this maximum amount.  The benefit year may be a calendar year or a fiscal year depending on how your plan is structured. Once your new plan year begins, your benefits are replenished back to where you started.  Unfortunately, if you don't use your benefits, you lose them as they won't roll over to the next year.  
  • DEDUCTIBLE - Yearly deductibles typically range from $25-$100.  This is a yearly amount paid by you and must be met before benefits are paid. This is collected by the dental office at time of service.  Many dental plans do not require you pay this deductible during your initial diagnostic and/or preventive visit (routine cleaning, x-rays, exams), but it will kick in when you have other treatment performed.  
  • FREQUENCY LIMITATIONS - This is the number of times your plan will cover a certain procedure within your plan year. Frequency limits are put into place by carriers as a way to control their costs and limit the amount in benefits they are obligated to pay out.  This should not be construed as a way in which they are dictating treatment... only you and your provider know the treatment you need and how often you need it.  For example:  Many plans allow 2 dental cleanings per plan year. This is typically what a patient with healthy teeth and gums will need, but sometimes, a patient needs a cleaning more often in order to improve and/or maintain their oral health.  If this is the case, the patient may incur the 3rd cleaning out of pocket.  Some plans will allow more cleanings if perio disease is present, the patient is pregnant, or wearing braces.
  • CO-PAY or PATIENT SHARE- Your Co-Pay or Patient Share is the percentage of the treatment you must cover that your plan will not.  For example, if the fee is $100 and your plan covers 80%, your share would be $20.  Unfortunately, some dental plans may reduce the benefit they will pay leaving you with a larger balance. When dealing with more expensive procedures, it's best to ask your dental provider to send in a pre-treatment authorization prior to treatment, so you can be certain of your share.
    • OTHER WAYS DENTAL CARRIERS CUT THEIR COSTS... DOWNGRADING BENEFITS ON FILLINGS/CROWNS/ONLAYS - Many plans will downgrade the benefit they'll pay for fillings and/or crowns/onlays to "lesser materials."  This means they'll pay a lesser amount on a lesser quality procedure, but will still pay some benefit.  For example:  White resin fillings on back teeth are commonly downgraded to the old amalgam material (silver fillings).  Again, this is not the dental carrier dictating that the filling should have been an amalgam over resin, rather it's the carrier's way of cutting their costs by paying out less in benefits. Unfortunately, when the carrier does this, the patient is left with the remaining bill.  Frequency limits will also apply.  Average limit for Fillings - 2 years, for Crowns/Onlays/ Bridges - 5+ years.  However, we have seen some plans state 10 years!
    • COSMETIC PURPOSE vs. NEED - Most plans will not cover procedures for cosmetic purposes.  
  • MISSING TOOTH CLAUSE - Many plans impose a "missing tooth clause" which means they may not cover a procedure involving a tooth that was missing prior to the plan starting.  
  • WAITING PERIOD- Many plans will impose a waiting period on select services.  This is especially true with individual dental plans.
  • EXCLUSIONS - Many plans will not allow certain services.  When in doubt, ask us!  We'd be happy to check for you!