Financial FAQ

How much does the surgery cost?
What are acceptable forms of payment?
What if I can not make my payments after the surgery?
What if I have no money at all?
What are the payment options?
What if I want to do long-term payment plans but my credit is insufficient to get financing?
What does my dental insurance cover?
What may be considered under my medical insurance?
What procedures are not likely to be covered by dental / medical insurances?
Can I get insurance before my planned oral surgery?
What are deductibles, maximal allowable, annual limits, percent coverage, etc?
How do in-network and out-of-network benefits differ?
What is interest-free financing?
How do I apply?
What are the qualifications?
Once I am qualified, what do I do?
What can I do if I am not approved?


How much does the surgery cost?

The cost of surgery depends on type of procedure, degree of difficulty, and type of anesthesia. For this reason, An initial evaluation is necessary to establish diagnosis and treatment options. A treatment plan is then presented with the recommended procedures and fees that meet your treatment goals and financial needs. Those with insurance may choose to pay the fees and receive reimbursement directly from their insurance company, or pay an approximate co-pay and we will submit the necessary claims. Various payment plans are also available to help spread the cost over time and make it more manageable.


What are acceptable forms of payment?
Cash, checks (with 2 forms of ID), and all credit cards are accepted. You may also pay online through our website using Paypal.


What if I can not make my payments after the surgery?
If you have trouble meeting your payment requirements according to the financial agreement, let us know. We understand difficult situations that may arise and we are more than happy to work with you. We can redesign a plan that spreads your payment over a longer time. In the event we don’t hear from you and your account becomes overdue, your account will be given to a collection attorney, at significant cost to you. Please let us know if you have financial difficulty so we can help.


What if I have no money at all?
We might be able to make recommendations for clinics or teaching facilities that might provide assistance.


What are the payment options?

  • Payment in full: We will provide you with an insurance claim packet for direct reimbursement by your insurance company.

  • Insurance co-payment: You will pay your deductible, approximate co-payment, and any amount above your annual limit. We will submit insurance claim on your behalf and wait for insurance payment towards your account. A 60-day agreement is required, along with an active credit number on record. Any balance beyond 60 days will be automatically charged to your credit card on file.

  • 2-month office payment plan: Requires a financial agreement and an active credit card number on file. Your installment will be automatically charged to your card on the appropriate payment date.

  • Long-term payment plans: This is a three- to 12-month (or longer) payment plan offered by third party financing company (Carecredit). A short application (via phone or website) is necessary, along with credit check for approval. You will make payments directly to the company. This is a NO-INTEREST program, and only a one-time service charge may apply. Speak to our financial coordinator for details or contact www.carecredit to apply.



What if I want to do long-term payment plans but my credit is insufficient to get financing?
There are two options:

  • You can ask a family member or friend to become a co-applicant and assist you with the approval process.

  • Make installment payments towards the cost of your procedure directly to the office. When you have completed your payments, you can schedule your procedure. We will keep accurate records of your payments. If at any time you change your mind, we will be happy to reimburse 100% of your contributions.



What does my dental insurance cover?
If you have a PPO dental insurance plan, it can offer benefits for teeth extractions (including wisdom teeth), anesthesia, and some biopsy procedures. Simple bone-grafting procedures may be covered under some plans. We are not member of any HMO plans and can not accommodate them.

Download our Insurance Options Brochure.


What may be considered under my medical insurance?
Biopsy procedures, traumatic injuries, and some bone grafting procedures for reconstructive purposes may be considered under medical insurances. Dental implants may also be considered if tooth loss was result of trauma or significant pathology such as cysts. Corrective jaw surgery (orthognathics) is also considered under medical insurance although many have specific exclusions.


What procedures are not likely to be covered by dental / medical insurances?
Dental implants, some bone grafting procedures, cosmetic procedures, and some corrective jaw surgeries are considered elective and therefore not likely to be covered by either dental or medical insurances. You may contact your insurance company for specific rules regarding coverage for these procedures.


Can I get insurance before my planned oral surgery?
You may choose to obtain dental or medical insurance for your desired oral surgery, but make sure to inquire about specific benefits for such procedures, exclusions, and waiting periods for pre-existing conditions. In most situations, insurance does little to help patients with their oral surgery cost.


What are deductibles, maximal allowable, annual limits, percent coverage, etc?
Deductibles are a fixed amount that you must pay out-of-pocket before benefits are considered. Depending on your specific plan, this may be $50-$250 for some dental insurances or as high as $2500 for some medical insurances.
Maximal allowable, also known as usual, customary and reasonable rates (UCR), refers to a fixed amount that your insurance company has allocated for a specific procedure, based on the procedure itself and zip code of the provider. For example, the maximal allowable for a tooth extraction may be $300. Your insurance company will base this amount for calculation of your benefits and may reimburse 50 to 100 percent of it based on your plan type. Any amount of the actual fee for the extraction not covered or above the maximal allowable will be your responsibility.
Annual limits: Dental insurances have maximal annual limits for benefits. The majority are $1,000 to $1,500 per year, per individual, but may be as low as $750 or as high as $5000 (for more premium insurance types). Any dental claims submitted are considered as long as you have available funds in your annual limit. These benefits typically expire at end of calendar year (usually Dec. 31st) and are not transferable.
Percent coverage: The benefits for each procedure may be 50 to 100 percent of the UCR amount. The majority of extractions and anesthesia services are covered at 80% of the UCR. Evaluations and x-rays are often covered at 100% of the UCR. Some insurance companies put limitations on panorex x-rays to one every three years.


How do in-network and out-of-network benefits differ?
Our office is not a member provider with any insurance plan, however we can accommodate many insurance plans as out-of-network provider. Many ask what that means to them and their out-of-pocket expense?

In-network providers follow the UCR value as the maximum they can charge you, while out-of-network providers can charge you the difference between their fee and the UCR. Here are some facts important to note:

  • The difference in our fees and the the UCR for most insurance companies are relatively small and make little difference in your out-of-pocket expenses.

  • Deductibles, annual limits, and percentage of the coverage remain the same whether you see an in-network or out-of-network provider, and therefore makes no difference.

  • Procedures like dental implants and bone grafting procedures are considered elective and therefore not covered, whether you go to an in-network or out-of-network provider.

  • If you have significant oral surgery needs and the fees go beyond your annual limits (example: $2,500 fees for your oral surgery needs with $1,000 available), you remain responsible for the difference ($1,500 in this example) and in- or out-of-network status makes no difference.

  • If you have minor oral surgery, the difference between in- or out-of-network providers is negligible.


Considering all the facts, it’s best to choose an oral surgeon based on your dentist’s recommendations, your trust and confidence rather than what your insurance company dictates.


What is interest-free financing?
Interest-free financing is a payment option for medical and dental procedures, administered by a third party financial company. This is essentially a loan. We offer three- to 12-month (or longer) payment plans. Following procedure or treatment, you will make monthly payments. This is a NO-INTEREST program.


How do I apply?
A short application (via phone or website) is necessary, along with credit check for approval. Once approved, you do not have to pay any fees to our office. Speak to our financial coordinator for details or contact the companies below to obtain line of credit. We offer these programs through the following companies:

CareCredit: 800-365-8295 www.carecredit.com
Lending club: 800-630-1663 www.lendingclub.com/patientsolutions/


What are the qualifications?
A routine credit check and application is necessary for qualification. Once approved, you may use all or part of the approved amount.


Once I am qualified, what do I do?
Once you are approved, you can call our patient care coordinator and inform them of your approval status. You can then schedule your surgery. On day of surgery, you will sign a form indicating that the services were provided.


What can I do if I am not approved?
These programs require you to have a good credit. If you are not approved, there are several options:

  • You can ask a family member or friend to become a co-applicant and assist you with the approval process.

  • Make installment payments towards the cost of your procedure directly to the office. When you have completed your payments, you can schedule your procedure. We will keep accurate records of your payments. If at any time you change your mind, we will be happy to reimburse 100% of your contributions.