Insurance Submission Timelines

Patient Arrival and Information Submission:

  • Provide your insurance details (medical and dental) and personal information when scheduling your appointment.
  • Update us of any changes to your insurance policy or personal details as soon as they occur. Inaccurate information can prevent timely delivery of an insurance estimate or claim submission.

Verification of Benefits (Day of Consultation):

  • Our office verifies your insurance benefits to estimate the coverage and your potential out-of-pocket costs.
  • If we are unable to verify insurance coverage, you will be responsible for the total costs of evaluation and treatment on the day of your appointment.

Payment of Estimated Costs:

  • You are required to pay the estimated out-of-pocket costs on the day of treatment, based on the initial benefit verification.

Treatment and Claim Submission:

  • Undergo the necessary dental treatment.
  • We file an insurance claim on your behalf, including all necessary documentation (such as treatment records and x-rays).

Insurance Claim Processing (Typically 4-6 Weeks):

  • The insurance company processes the claim.
  • We await confirmation and payment from the insurance company.
  • If there are multiple insurances or a combination of medical or dental insurance, this can be 4-6 weeks per company.
    • i.e. Primary and secondary dental coverages can take 8-12 weeks to fully process.

Handling Denials:

  • If a claim is denied, our office will review the reasons for denial and either appeal the decision or provide you with a detailed explanation and next steps.
  • We may contact you for additional information if needed for the appeal.
  • If a claim is denied after appeal, you remain responsible for the total cost of treatment.
  • We encourage patients to appeal any denial, and we are happy to assist you.

Finalization of Account:

  • Once payment is received from the insurance company or after resolving any denials, we update your account.
  • If there is any balance due after the insurance payment, it is due upon notification. If you have overpaid based on the final insurance payment, we issue a refund.

IMPORTANT:

BECAUSE OF INSURANCE PROCESSING TIME, YOU MAY NOT RECEIVE YOUR BILL OR REFUND UNTIL 1-3 MONTHS AFTER YOUR TREATMENT AND SUBMISSION TO INSURANCE

Exceptional Oral Surgery Care at Hermitage Oral & Maxillofacial Surgery

Experience outstanding oral surgery with state-of-the-art technology, specialized services, and no referrals required. Discover compassionate care and exceptional results at Hermitage Oral & Maxillofacial Surgery.

Call us: (615) 883-0067