In-Network Provider:
Southwestern PA Endodontics is a participating provider (in-network) with several dental insurance carriers. This means that we are contracted to accept the payments offered by the insurance carrier rather than our own office fees for each procedure(s). There are many benefit plans that are covered under the same insurance carrier. Even if you do not see your benefit plan listed, it still may be covered as part of our in-network provider agreement.
Our office staff will work hard to verify your estimated benefits before your next appointment. They will do their best to explain the steps involved to maximize your benefits and submit your claims. A detailed explanation of your insurance benefits will be provided, if possible, so that you will be informed of your financial responsibilities before your appointment.
If we participate with your dental plan, you will be required to pay the estimated co-payment which may include a deductible if it has not been met. While we try to provide you with the most up-to-date costs, your portion is only an estimate. Because the status of your benefits may not include recently submitted claims, we can only provide an estimation from the current status of your benefits. Finally, your responsibility will also depend on whether or not you have reached your annual allowable maximum.
Please keep in mind that verification of your benefits is only an estimate and not a guarantee. If we are unable to verify your insurance benefits, you will be responsible to pay the full amount or make payment arrangements in full at the time treatment is rendered. We will continue to try and confirm your benefits and submit necessary claim forms for you.
Out-of-Network (Non-Participating) Provider:
There is a common misconception that you do not receive any benefits from your dental plan unless you accept treatment under an in-network provider. This is not true in most cases. Most dental benefit plans have out-of-network benefits.
We will still try to verify your current status and benefits with your insurance company and submit your claim forms for you. In this instance, you will make your payment in full at the time of treatment and your insurance company will pay its portion directly back to you.
Please note: we verify an estimation of your benefits as a courtesy to you. We highly recommend that you contact your benefits plan and verify your own coverage.
Patients without Dental Benefits:
Patients without any dental benefits plan will pay for our services at Southwestern PA Endodontics’ fees. We require that all patients’ balance be paid in full at the time of the actual treatment. We accept Visa, Mastercard and CareCredit.
