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Frequently Asked Questions

Q. What is a Pediatric Dentist?

A Pediatric Dentist has at least an extra two years of specialized training after dental school, and is dedicated to the oral health of children from infancy through the teenage years. The very young, pre-teens, and teenagers all need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems. The pediatric dentist is best qualified to meet these needs.

Q. What age should I first bring my child to the dentist? 

 Our office, as well as the The American Academy of Pediatrics (AAP), the American Dental Association (ADA), and the American Academy of Pediatric Dentistry (AAPD) all recommend establishing a "Dental Home" for your child by one year of age.  Children who have a dental home are more likely to receive appropriate preventive and routine oral health care.  We feel the key to maintaining a healthy smile and positive dental attitude is to start early with preventive measures and education for our patient's families. 

Q. Can I stay with my child during the visit?

We invite you to stay with your child during the initial examination.  During future appointments, we suggest you allow your child to accompany our staff through the dental experience.  We can usually establish a closer rapport with your child when you are not present.  Our purpose is to gain your child’s confidence and overcome apprehension. However, if you choose, you may come with your child to the treatment room.  Other children who are not being treated will need to remain in the reception area with a supervising adult.

Q. What are your scheduling guidelines?

Your scheduled appointment time is reserved specifically for your child. If a cancellation is unavoidable, please call the office at least 48 hours in advance so that we may give that time to another patient. In addition, if you arrive late for your appointment, you may be asked to reschedule for the next available appointment time. Again, please call at least 48 hours in advance if a cancellation is unavoidable so that we may give the appointment to another patient. One missed appointment without a 24-hour prior notification is considered a "no show" appointment and will result in a $50 rescheduling fee.  During the school months, late afternoon appointments are in high demand.  We try to honor after school requests, but have a very limited amount of time after school hours.  We ask that you help us by understanding when we need to appoint during school hours.  We will gladly provide you with a school excuse for your child.

Q. Who can bring my child to their appointment?

A parent or legal guardian (with official documentation) must be present in the office during the initial examination and any operative appointments.

Q. What payment methods do you accept?

Payment for professional services is due at the time dental treatment is provided. Every effort will be made to provide a treatment plan which fits your timetable and budget, and gives your child the best possible care. We accept cash, personal checks, debit cards and most major credit cards.  Financing is also available through Care Credit.

Q. Will you file my dental insurance claim?

If we have received all of your insurance information on the day of the appointment, we will be happy to file your claim for you. You must be familiar with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay. By law your insurance company is required to pay each claim within 30 days of receipt. We file all insurance electronically, so your insurance company will receive each claim within days of the treatment. You are responsible for any balance on your account after 30 days, whether insurance has paid or not. If you have not paid your balance within 60 days a re-billing fee of 1.5% will be added to your account each month until paid. We will be glad to send a refund to you if your insurance pays us.

PLEASE UNDERSTAND that we file dental insurance as a courtesy to our patients. We do not have a contract with your insurance company, only you do. We are not responsible for how your insurance company handles its claims or for what benefits they pay on a claim. We can only assist you in estimating your portion of the cost of treatment. We at no time guarantee what your insurance will or will not do with each claim. We also can not be responsible for any errors in filing your insurance. Once again, we file claims as a courtesy to you.

Q. Will my dental insurance cover services at 100%?

NO INSURANCE PAYS 100% OF ALL PROCEEDURES

Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 90%-100% of all dental fees. This is not true! Most plans only pay between 50%-80% of the average total fee. Some pay more, some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage, or the type of contract your employer has set up with the insurance company.

Q. How is it determined what my insurance will pay?

BENEFITS ARE NOT DETERMINED BY OUR OFFICE

You may have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist's actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist's fee has exceeded the usual, customary, or reasonable fee ("UCR") used by the company.

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable, or well above what most dentists in the area charge for a certain service. This can be very misleading and simply is not accurate.

Insurance companies set their own schedules, and each company uses a different set of fees they consider allowable. These allowable fees may vary widely, because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a level they call the "allowable" UCR Fee. Frequently, this data can be three to five years old and these "allowable" fees are set by the insurance company so they can make a net 20%-30% profit.

Unfortunately, insurance companies imply that your dentist is "overcharging", rather than say that they are "underpaying", or that their benefits are low. In general, the less expensive insurance policy will use a lower usual, customary, or reasonable (UCR) figure.

Q. What out-of-pocket costs will I pay with my insurance?

YOU ARE RESPONSIBLE FOR DEDUCTIBLES, CO-PAYMENTS, AND ANY SERVICES NOT COVERED BY YOUR INSURANCE PROVIDER

When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary (UCR) fee, we can figure out what benefits will be paid. First a deductible (paid by you), on average $50, is subtracted, leaving $100.00. The plan then pays 80% for this particular procedure. The insurance company will then pay 80% of $100.00, or $80.00. Out of a $150.00 fee they will pay an estimated $80.00 leaving a remaining portion of $70.00 (to be paid by the patient). Of course, if the UCR is less than $150.00 or your plan pays only at 50% then the insurance benefits will also be significantly less.

MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.

In certain unusual circumstances, an account balance may occur. Sunflower Smiles Pediatric Dentistry requires all outstanding balances to be paid in full within 30 days unless other arrangements have been made.