Periodontal Center of Excellence is a fee for service periodontal practice. Our doctors are not in network providers for HMO/PPO plans, however it is an individual patients right to seek care in an office of their choosing, regardless of whether that doctor is a provider or not.
Insurance is provided through your employer who contracts with the insurance company. The type and amounts of coverage you receive is based upon negotiations between these two organizations and can change frequently. Services covered by your insurance company are dependent upon the cost of the insurance policy to your employer and what the insurance company is willing to pay. We file treatment related insurance claims as a courtesy to our patients, but we will not become involved in disputes between you and your insurance regarding deductibles, co-payments, covered charges, secondary insurance, “usual and customary” charges, etc.
Unlike medical insurance, once this maximum has been reached there is no additional coverage provided by your insurance company for that calendar year. Many patients presume that a pre-treatment estimate of procedures is needed prior to proceeding with oral therapy; when in fact, there are only very few insurance companies that require pre-treatment estimates.
Several of the services offered at Periodontal Center of Excellence, such as dental implants and periodontal plastic surgery are not typically covered by most dental plans. We have found however, that some companies will cover implants. If your insurance company provides these benefits, we will be happy to submit an insurance claim, following treatment, to obtain reimbursement for our patients.
Our highly trained insurance coordinators work with many different insurance companies every day. Insurance companies change policies and guidelines frequently; and at times, it is difficult to accurately estimate the patient’s out-of-pocket expense for surgical therapy in our office. As a courtesy to you, our patient, we are more than happy to process a pre-treatment estimate and surgical claim on your behalf. So that we can expedite your reimbursement, please bring your insurance information with you to the consultation appointment. It is important that you keep the insurance information on file in our office current at all times.
Our goal at Periodontal Center of Excellence is to provide you with the most state of the art and highest quality of care, and insurance coverage should be a minor factor in your decision to achieve optimal oral health. If you have any questions, please contact our front desk at 281-292-1833.