Office Policies
About Us
How are appointments scheduled?
Do I stay with my child during the visit?
What about finances?
Our Office Policy Regarding Dental Insurance
About Us
Westfield Pediatric Dental Group has been providing comprehensive dental care for infants, children, adolescents, and special needs patients for 50 years. Our child-friendly atmosphere is customized to make children and their parents feel comfortable at the dentist. Parents are welcome to sit with their child during their dental visit.
A pediatric dentist has an additional two years of specialized training and is dedicated to the oral health of children.
Your child should visit the dentist by his/her first birthday. You can make the first visit to the dentist enjoyable and positive. Older children should be informed of the visit to the dentist and told that the dentist and his staff will explain all procedures and answer any questions.
Your children are your most precious possessions. If you can keep them in good health, you will give them a fine start toward a happy life. Dental health is an integral part of total health, both mental and physical, and should be provided meticulously and regularly. The pediatric dentist is available to serve the special dental health needs of your children.
How are appointments scheduled?
The office attempts to schedule appointments at your convenience and when time is available. Preschool children should be seen in the morning because they are fresher and we can work more slowly with them for their comfort. School children with a lot of work to be done should be seen in the morning for the same reason. Dental appointments are an excused absence. Missing school can be kept to a minimum when regular dental care is continued.
Since appointed times are reserved exclusively for each patient we ask that you please notify our office 24 hours in advance of your scheduled appointment time if you are unable to keep your appointment. Another patient, who needs our care, could be scheduled if we have sufficient time to notify them. We realize that unexpected things can happen, but we ask for your assistance in this regard.
Do I stay with my child during the visit?
Our top priority is making both the parents and the children feel as comfortable as possible during each dental appointment. We want the dentist to be a FUN place to be, a place where children are excited to come and learn how important it is to have healthy teeth that will last a lifetime.
The dentists and clinical team at WPDG allow parents to accompany their children for their dental appointments. We happily want the parents back during these visits as you provide very important information about your child’s medical and dental history. We also want to make sure we answer all of your questions during these appointments.
What about finances?
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 will submit to most dental insurances. Please call our office and speak to our insurance specialist who will help coordinate the use of your dental benefits in our office. We accept cash, personal checks, debit cards, Care Credit, and most major credit cards.
This office does not accept Medicaid or New Jersey Kid Care. We refer these patients to Rutgers Newark Dental Program (973) 972-7370, and Morristown Memorial Hospital (973) 971-5442.
Our Office Policy Regarding Dental Insurance
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.
Fact 1 - NO INSURANCE PAYS 100% OF ALL PROCEDURES
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.
Fact 2 - 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.
Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED
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.
