Important changes to how we will process insurance claims

Dear valued patient,

What’s Happening?

We want to inform you of important changes to how we will process insurance claims. In the next few months, we will be ending our in-network participation with your PPO dental insurance company. For the exact end date, feel free to contact us. Don’t worry, we will still accept your plan and can use your dental benefits, but we will become an OUT-OF-NETWORK provider going forward.

The reasons for our decision:

We have been in-network with your insurance company for years and had hoped to remain this way. However, when a dentist contracts with an insurance company to become an in-network provider, they must accept the dental fees set by the insurance company. In the almost 8 years since we’ve been an in-network provider with your insurance company, we’ve been very disappointed to see that they have neglected to make a single increase to the fees for the dental treatment we provide. This means that the amount we charge for a procedure such as a cleaning, filling, or crown is the exact same as it was eight years ago.

With our rising yearly operating costs including rent, utilities, dental materials, payroll, supplies, dental lab fees, protective equipment, licenses, etc., it has become increasingly difficult to remain in-network and continue to provide the level of dental care that is so important to both you and us. Your dental health is too important to compromise, and we remain focused to maintain the highest standards of care that you have become used to in our office. Consequently, we have decided to no longer be contracted with your insurance company.

How will this affect you?

As a commitment to our patients, once we become an out-of-network provider, we will strive to keep our fees reasonable and fair for the services we provide. You can remain a patient of ours and we’ll help secure all the insurance benefits that you have. You may receive a letter from your insurance company in the near future which may recommend that you find another dentist. We hope that the experience you’ve had with us will encourage you to remain with our practice. Please know that we remain deeply committed to you and your oral health. Because your dental health comes first, we must make these changes in order to maintain the high level of service, quality of materials, and meticulous care you deserve.

We’re happy to answer any questions you have and look forward to your next visit!

How the claims processing will change

1. Payment in full will be kindly expected from you at the time of service.

hen you come to the office, we’ll review the fees for the services you’ll receive that day.

2.Once the appointment is complete, if you desire, we will gladly send a claim as a courtesy to you. Once they process the claim, the insurance company will then directly send you any payment for procedure the plan may cover.

Depending on the insurance company and the type of treatment completed, this can typically take anywhere from 2-6 weeks.

3.Please note that although we can send the claim to the insurance company (along with any required x-rays, photos, narratives, and supporting documentation), it will be your responsibility to follow up to ensure that you’ve received payment from them.

If you encounter a problem and can’t resolve it with your insurance company (such as if they’re requesting more information regarding a dental procedure that was completed), please contact us and we’ll be happy to assist you.

4. If you would like to know what dental benefits you have for a specific dental procedure ahead of time, please let us know and we can send a pre-authorization request to your dental insurance company.

Depending on the company and the type of treatment to be performed, this can typically take anywhere from 2-6 weeks. The pre-authorization is a written estimate of what the insurance company is expecting to pay for a dental procedure we are planning. Typically, both the patient and dental office will receive a copy of the preauthorization. However, this can vary from company to company. Once you receive this document, if you need assistance reviewing and understanding it, please let us know and we will gladly assist you.

Location: 1060 E Green St #203, Pasadena, CA 91106