Office Policies

Appointments

We try to see all of our patients on an appointment basis and will reserve a scheduled appointment exclusively for your child. We make every effort to schedule your child’s appointment so you will not be kept waiting. We realize your time is important, too! We try to schedule our operative appointments (fillings, extractions, etc.) during the morning when kids are “fresh” and better able to cooperate for these procedures.

Please note we do see dental emergencies and please accept our sincere apology if this should lead to a delay in your child’s appointment. If your child has an accident, please call our office as soon as possible. We will see your child immediately. We always have an On-call Doctor available for after-hour emergencies.

Please contact our office at least 24 hours in advance if you are unable to keep your scheduled appointment. Any change in your child’s appointment affects all of our other patients for that day. If you have 2 missed or canceled appointments without 24 hours notice we do reserve the right to not schedule any more appointments for your family.

Financial Policy

We accept cash, check, major credit cards, private dental insurance, Medicaid, and NC Health Choice. We are in network providers for Delta Dental, Blue Cross Blue Shield, Ameritas, and some Cigna plans. Payment for your portion of the treatment that is not covered by your insurance is due at the time of treatment. The parent or guardian that brings the child to the appointment is legally responsible for payment. We do participate with Care Credit as an easy way for our patients to obtain financing for treatment.

Please bring your current insurance card to each visit. As a courtesy to our patients we will accept assignment of benefits from your insurance carrier which means that we will accept payment from your insurance carrier and ask that you only pay your estimated portion at the time of the appointment. You can help us by familiarizing yourself with your insurance coverage since benefits vary among plans. We will assist you in maximizing your full benefits, but please understand that your insurance is a contract between you, your employer and insurance company, not our office and your insurance company.

A Brief Description of How Dental Insurance works

Dental insurance rarely pays for 100% of a procedure. Dental insurance should not be viewed as the sole manner of payment for dental services but as an aid when paying for dental care. Many plans will pay most all of the charges for a 6 month check-up but these same plans generally will only cover 50-75% of other dental procedures such as fillings or extractions. The amount that your plan pays is usually directly related to how much you or your employer pays for the plan.

Our office does not determine any of your reimbursement benefits with your insurance company. Each insurance company creates its own fee list that is calls the usual, customary, or reasonable fee (UCR). The insurance company collects data on fees from the all the different dental insurance claims that it sees from all parts of the country. Then the insurance company uses this data to select a fee for a procedure that it deems to be the allowable UCR fee that “allows” the insurance company to make a profit that is usually in the 25% range. Many times, the data used to create the UCR fee is also several years old.

As a result, the UCR fee that your insurance company pays is usually less than the fee at most dental offices. The insurance company may give the impression that the dentist is charging to much when in reality the insurance company just has set a lower UCR fee that is more advantageous to the insurance company. The UCR fee that the insurance company will pay for a procedure is usually related to how much the insurance premium is. The more expensive plans usually reimburse the dentist with a higher UCR fee than the plans that are less expensive.

Insurance plans also have deductibles and yearly limits. Your deductible is determined by your insurance plan and will be an amount of money you must pay before your insurance starts paying. For instance, your deductible may be $50 for a year so the first $50 of dental charges in a calendar year are your responsibility and then the dental insurance will begin paying on the normal benefits for the rest of that year. Most insurance plans have a maximum of $1000 or $1500 that they will pay in a year. If a patient has a large treatment plan that costs more that this yearly limit then any charges over the yearly limit would be the patient’s responsibility.

As a courtesy to our patients we will accept assignment of benefits from your insurance carrier which means that we will accept payment from your insurance carrier and ask that you only pay your estimated portion at the time of the appointment. Our dental software will estimate how much your dental insurance is expected to pay and all that we ask is that you pay the rest. Please note that our software can only estimate how much your insurance will pay and it is yoru responsibility to be aware of what you dental benefits are. For example, if your charge is $100 and our computer system estimates that your insurance will pay $60 then we would ask that you pay $40 at the time of service. If you insurance instead comes back and only paid $50 then you would still have a $10 balance on your account.

Parental presence

A parent or legal guardian must accompany a child to his/her first dental visit. We understand that it may be necessary to have someone other than the legal guardian bring the child to subsequent visits and can provide necessary paperwork to be completed for this purpose. Your child’s treatment plan must be signed by the parent or legal guardian prior to rendering dental services. This serves as consent as well as accepting responsibility for any balance due.

One parent or guardian is welcomed to come back into the treatment area with the patient for any appointment if they wish. All other adults and children should remain in the waiting room for the safety and privacy of other patients. Most children 3 and younger do much better with the comfort of a parent present and we do highly recommend that parents accompany children of this age for their visits. Older children sometimes do better without their parents present. If we think your presence is negatively affecting your child’s behavior we will discuss this with you. We do have windows in the doorways of all of our operatories so if you do not wish to be present in the operatory for your child’s treatment you can still peek in as a silent observer.

OCR Notice of Nondiscrimination

Source: HHS Office for Civil Rights

Notice Informing Individuals About Nondiscrimination and Accessibility Requirements and Nondiscrimination Statement: Discrimination is Against the Law

Triangle Pediatric Dentistry complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Triangle Pediatric Dentistry does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Triangle Pediatric Dentistry:

  • Provides free aids and services to people with disabilities to communicate effectively with us, such as:
    • Written information in other formats (large print, accessible electronic formats, other formats)
  • Provides free language services to people whose primary language is not English, such as:
    • Qualified interpreters
    • Information written in other languages

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

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