This page explains the office policy regarding dental insurance, claim filing, and your financial responsibility.
Dental Insurance in Cypress, TX and Houston, TX
Our Office Policy Regarding Dental Insurance
Our office policy outlines how dental insurance claims are filed, how estimated portions are collected, and when any remaining balance becomes your responsibility.
If all of your insurance information has been received on the day of the appointment, the office will file your claim for you. All insurance is filed electronically so that the insurance company receives each claim within days of the treatment.
It is important that you are familiar with your insurance benefits, because the office will collect the estimated amount that your insurance is not expected to pay. This estimated amount is based on the information available about your coverage at the time of treatment.
By law, the insurance company is required to pay each claim within 30 days of receipt. You will be responsible for any balance on your account after 30 days, whether insurance has paid or not. If the insurance company pays the office after you have already paid this balance, the office will be happy to send you a refund.
Our Office and Your Dental Insurance Company
This section explains the relationship between the office and your dental insurance company, including the limits of what the office can control and guarantee.
Dental insurance is filed as a courtesy to patients. The office is not responsible for how the insurance company handles its claims or for what benefits the insurance company chooses to pay on a claim.
The office does not have a contract with your insurance company; only you do. Because of this, decisions about claim handling and benefits rest with the insurance company and the terms of your policy, not with the office.
The office can only assist you in estimating your portion of the cost of treatment. There is no guarantee of what your insurance will do with each claim unless a written preauthorization has been filed.
What Dental Insurance Usually Covers
This section describes how dental insurance is intended to help with the cost of care and how coverage levels are determined.
No insurance company pays 100% of all procedures, and the benefits are not determined by the office. Dental insurance is meant to be an aid in receiving dental care rather than full payment for all services.
Most dental plans only pay between 50% and 80% of the average total fee. Some plans may pay more and some plans may pay less, depending on the specific plan.
The percentage paid by the insurance company is usually determined by how much you or your employer has paid for coverage, or by the type of contract your employer has set up with the insurance company. Please keep the office informed of any insurance changes such as policy name, insurance company address, or a change of employment.
Why Families Choose Houston Pediatric Dental Specialists
Parents want a pediatric dental team that understands children, communicates clearly, and creates an environment where visits feel easy and uplifting. That’s exactly what sets us apart.
Get Started at Houston Pediatric Dental Specialists
Whether it is your child’s first visit or you are looking for a new pediatric dental home, Houston Pediatric Dental Specialists makes it easy to get started in Cy-Fair or Cypress. Choose the location that works best for your family, pick a time that fits your schedule, and arrive knowing your child will be cared for by a friendly, pediatric-focused team.