Dental Benefit Explanation Form

  • It is our policy to provide the best dentistry for you. To do this, it is important that we do not allow dental benefits to be a determining factor in the diagnosis. Your treatment will be based upon your needs, and we assume that you are as concerned as we are about maintaining your good health.

    The term "dental insurance is misleading. What is commonly known as "dental insurance" is more correctly termed dental benefits. Dental benefits are not intended to pay everything, but to assist with costs of dental treatment. Generally, dental benefits pay a percentage of each procedure up to a set yearly maximum. The benefits available to you are established by which plan package your employer has purchased or you have purchased on your own.

    As a courtesy to you, we will submit claims to your dental plan carrier. We also accept benefit assignment, meaning that we will estimate the expected benefit payment and allow you to pay your estimated portion at the time services are provided. However, we do not guarantee any estimate, and should your dental plan pay less than expected, you are fully responsible for the balance. We take no responsibility for any denials by dental plans.

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