About Us

Our practice specializes in Endodontics. Our services include primarily root canals and dental implants. Our practice sets itself apart from others with our friendly office staff, state-of-the-art equipment, and highly skilled dental professionals. We have the answers to your questions regarding dental insurance and are happy to fully explain the procedure and options. We encourage you to call our office and come in for a consultation with Dr. Kelliny. We have convenient office hours and convenient location.

If you would like, please download and fill-out the following forms prior to your appointment.

 

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Dental Benefits - A Guide

Your endodontist wants you to understand how dental insurance works and how to make it work best for you, You should also understand how the treatment your endodontist provided works with your dental plan.

The contract your employer negotiated with your insurance carrier defines your dental benefits. Various dental plans cover endodontic procedures at different payment levels and, as a result, your payment portion may vary.

1. What is a "UCR" and how is it determined?
"UCR" is the term used by insurance companies to describe the amount they are willing to pay for a particular endodontic procedure. There is no standard fee or accepted method for determining the UCR, and the UCR has no relationship to the fee charged by your endodontist. The administrator of each dental benefit plan determines the fees that the plan will pay, often based on many factors including region of the country, number of procedures performed and cost of living.

2. Why was my benefit different from what I expected?

    Your dental benefit may vary for a number of reasons, such as:
    You have already used some or all of the benefits available from your dental insurance
    Your insurance plan paid only a percentage of the fee charged by your endodontist.
    The treatment you needed was not a covered benefit.
    You have not yet met your deductible
    You have not reached the end of your plan's waiting period and are currently ineligble for coverage.

3. Why isn't the recommended treatment a covered benefit?


We diagnose and provide treatment based on our professional judgment and not on the cost of that care. Some employers or insurance plans exclude coverate for necessary treatment as a way to reduce their costs. Your plan may not include this particular treatment of procedure, although your endodontist deemed the treatment necessary.

4. How do I know what my payment portion will be if my insurance does not cover the entire fee?


Your payment portion will cary according to the UCR of your plan, your maximum allowable benefit and other factors. Ultimately, the patient portion is not known until the insurance check has been received by your endodontist.

5. How do I understand my Explanation of Benefits (EOB)

Your Explanation of Benefits (EOB) contains a wealth of information. The EOB identifies the benefits, the amount your insurance carrier is willing to pay and charges that are and are not covered by your plan. The statement includes the following information: UCR, copayment amount/patient portion, remaining benefits, deductible and benefit paid.

6. How long does it take for a claim to be paid?


The time for a dental insurance carrier to process an insurance claim varies. At least 38 states have enacted laws requring dental insurance carriers to pay claims within 30-45 days.




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