PPO Insurance

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Does Orthodontic Insurance work differently?

In most cases YES. The billing and paying cycle can take from 12 months to 24 months to complete. This is due to treatment length.

 

When will Dr. Yu's staff bill my insurance?

The initial claim will be processed immediately after the placement of your appliances and it could take 4 to 6 weeks before we see the first payment. Thereafter, monthly or quarterly billing is necessary.

 

Can I have the insurance money come directly to me?

Yes, if we send special documentation of your desire. However, Delta insurance will not allow it, as well as a handful of other carriers. In this case, we will expect you to handle all of your remaining billings.

 

How are my payments effected by my insurance?

All service agreements include a minimum payment plan. When a patient is also covered by insurance the number of payments will be reduced, but not the monthly minimum amount.

 

What happens if I change jobs in the first year of treatment and loose my insurance?

You insurance company is responsible to pay up to the last day of work. The remaining insurance balance will be your responsibility.

If I become eligible for orthodontic insurance after I have already started treatment, will it still cover my treatment?

In most cases NO, it would be considered a "pre-existing" condition and most policies have a one year waiting period after the eligibility date. However, we can only hope.

 

Do you know exactly what my insurance carrier will pay?

Unfortunately, with thousands of policies it is impossible to know for sure. We can not guarantee payment amount or eligibility for any insurance carrier. We are only able to give you general information we have received from your provider.

 

What happens if I have TWO insurances?

The primary insurance will be billed first. When the primary sends their EOB (explanation of benefits) we must send a copy to the secondary insurance company. Coordination is time consuming and can take up 90 to 120 days.

 

What do I need to bring with me for my consultation appointment?

Bring your insurance card and/or benefit booklet. We also need the Social Security number and date of birth for the employee/insured. We need to call to verify eligibility and benefits to help you fully understand your financial obligations. Feel free to call us with this information before your appointment so we may serve you better.

*Most insurance companies are closed on Saturday and Sunday.

 

H.S.A. & Flexible Spending Accounts

Many employers are offering employees a “Flexible spending account” for all medical and dental procedures. Each company makes their own rules and regulations on how the individual plan works. What they have in common, is pre-taxed money, placed in an account that must be used before the end of the business year or loose what is left.

Orthodontic treatment is usually a covered benefit. Just check with your Human Resources Dept for a more detailed explanation.

When you make a payment you will receive a receipt for orthodontic services, so you may recover your money from your account.