Payment Policy
Endodontic fees are based on the complexity of the procedure. You will be advised of the fee for each procedure at the time of consultation.
We are a fee-for-service practice. Since we do not take insurance assignment and do not directly participate as an insurance provider with any dental insurance carriers, we will prepare insurance forms for you to submit for reimbusement.
We welcome any questions you may have about payment and insurance benefits. We will make every effort to help you get reimbursed by your insurance carrier. Payment is due in full at the time of service. We accept personal checks, debit cards, VISA, MasterCard and Discover.
Insurance FAQs
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 our office. 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.
Why was my benefit different from what I expected?
Your dental benefit may vary because: you have already used some or all of the benefits available; your insurance plan paid only a percentage of the fee charged by our office; the treatment you needed was not a covered benefit; you have not yet met your deductible; or you have not reached the end of your plan’s waiting period and are currently ineligible for coverage.
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 coverage for necessary treatment as a way to reduce their costs. Your plan may not include this particular treatment or procedure, although we deemed the treatment necessary.
How do I know what my payment portion will be if my insurance does not cover the entire fee?
Your payment portion will vary 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 our office.
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, co-payment amount/patient portion, remaining benefits, deductible and benefit paid.
How long does it take for a claim to be paid?
The time for a dental insurance carrier to process an insurance claim varies. Maryland requires that dental insurance carriers pay claims within thirty days. If you want to file a complaint about a delayed payment, contact the Maryland Insurance Administration. They want to know if your insurance company does not pay within the required thirty days allowed by Maryland state law.
Will my endodontist take my insurance?
We will assist you in filing your insurance claimsa and you would receive any insurance benefits directly from your insurance carrier.
What if I still have questions?
We will do our best to answer all of your insurance questions. Please keep in mind that there are many insurance plans available and that your employer chooses your plan and your benefits. If you believe your benefits are inadequate, you may want to discuss the matter with your plan administrator and explore appropriate alternatives.
If you would like more information, please contact us
by telephone at 301-654-6077, or by e-mail at info@endocc.com