Phone:513.979.6998 Fax:513.979.6990 hppediatricdentistry@gmail.com

Insurance Guidlines

While we accept all dental insurance and are in-network with most PPO plans, we are not considered in-network with all insurance plans. Being out-of-network does not always mean you do not have benefits. We ask that you contact your insurance company to see what your out-of-network benefits are. We strive to help you make optimal use of your dental insurance and, as a courtesy to our patients, we are happy to file all your dental claims.

Your insurance is a contract between you, your employer and your insurance company. With the complexity of insurance policies and the constant changes made by insurers and employers, keeping up to date is challenging. Neither employers nor insurance companies notify us of any changes. Insurance companies have decided that it is the member’s responsibility to know their insurance limitations.

Please make sure that you have given us accurate insurance information at least 2 days prior to your child’s appointment. If we do not have your current information, the claim will be rejected, and unfortunately, you are responsible for the balance.

It is lengthy and costly for our office to reprocess rejected claims due to not having the correct insurance information. Insurance companies are very reluctant to speak with us directly regarding your individual plan. However, it is their job to answer all your questions by calling the toll free number provided on your insurance card or website. (Upon request, we are happy to send a predetermination when treatment is proposed to better estimate coverage.)

Questions you should ask your insurance:

  1. If I am out-of-network, what is my benefit level?
  2. What services are covered?
  3. Do I have a co-pay or deductible?
  4. Is fluoride covered 2 times per year?
  5. Has the insurance carrier, group number, or their address changed?

Not only do all the insurance companies differ in requirements and coverage, but their policies and procedures constantly change. While our office strives to keep up to date, the ultimate responsibility of knowing the current benefits remains with you. Thank you for helping ensure that we maximize your benefits!