Insurance and Billing

House of Smiles Pediatric Dentistry & Orthodontics is committed to making quality dental care accessible and affordable for all families. We work with most major insurance plans and offer flexible payment options to ensure your child receives the dental care they need without financial stress. Our knowledgeable billing team is here to help you understand your insurance benefits and explore payment options that work best for your family’s budget.

Accepted Insurance Plans

We work with a wide range of dental insurance providers and will help you make the most of your benefits. Contact our office, and our friendly team can verify your coverage for you. We do not accept Medicaid or HMO plans.

Major Insurance Providers We Accept
  • Delta Dental
  • Cigna Dental
  • Aetna
  • MetLife
  • Blue Cross Blue Shield
  • Humana
  • United Healthcare
  • Guardian
  • Principal
  • Anthem
  • Assurant
  • Lincoln Financial
  • Sun Life
  • Mutual of Omaha

We accept payments from FSA and HSA accounts, helping you use pre-tax dollars for your child’s dental care. These accounts can provide significant savings on dental treatments.

Understanding Your Dental Insurance

Benefits Verification

Our team verifies your insurance benefits before your appointment and provides you with a detailed explanation of your coverage. We'll inform you of your annual maximum, deductible, and coverage percentages for different types of treatments.

Benefits Verification

Our team verifies your insurance benefits before your appointment and provides you with a detailed explanation of your coverage. We'll inform you of your annual maximum, deductible, and coverage percentages for different types of treatments.

Coverage Levels

Most dental insurance plans operate on a tiered system:

  • Preventive Care (100% coverage): Routine cleanings, exams, X-rays, and fluoride treatments
  • Basic Restorative (70-80% coverage): Fillings, extractions, and basic procedures
  • Major Restorative (50% coverage): Crowns, root canals, and complex procedures
  • Orthodontic Coverage (50% coverage): Braces and other orthodontic treatments (when covered)

Coverage Levels

Most dental insurance plans operate on a tiered system:

  • Preventive Care (100% coverage): Routine cleanings, exams, X-rays, and fluoride treatments
  • Basic Restorative (70-80% coverage): Fillings, extractions, and basic procedures
  • Major Restorative (50% coverage): Crowns, root canals, and complex procedures
  • Orthodontic Coverage (50% coverage): Braces and other orthodontic treatments (when covered)

Annual Maximums and Deductibles

Most plans have annual maximum benefits (typically $1,000-$2,000) and deductibles that must be met before coverage begins. We'll help you understand these limits and plan treatments accordingly.

Annual Maximums and Deductibles

Most plans have annual maximum benefits (typically $1,000-$2,000) and deductibles that must be met before coverage begins. We'll help you understand these limits and plan treatments accordingly.

Payment Options

We offer various payment options to make dental care affordable for every family. Our goal is to ensure financial considerations don’t prevent your child from receiving necessary dental treatment.

Payment Methods Accepted

  • Cash
  • Personal checks
  • Credit cards (Visa, MasterCard, American Express, Discover)
  • Debit cards
  • Electronic transfers
  • FSA and HSA accounts

Payment Plans

We offer flexible payment plans for larger treatments, allowing you to spread costs over several months. Payment plans can be arranged with no interest for qualified families.

CareCredit Healthcare Financing

We partner with CareCredit to provide healthcare financing options with:

  • No interest if paid in full within promotional period
  • Extended payment plans with low monthly payments
  • Quick and easy approval process
  • Coverage for the entire family

Third-Party Financing

Additional financing options are available through various healthcare financing companies. Our team can help you explore these options and find the best solution for your needs.

In-House Membership Program

Please reach out for additional information.

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Billing Procedures

Insurance Claims Processing

We file insurance claims on your behalf and handle all communication with your insurance company. Our experienced billing team ensures claims are processed efficiently and accurately.

Direct Insurance Payments

When possible, we arrange for insurance payments to be sent directly to our office, reducing the paperwork and hassle for you. You’ll receive detailed explanations of benefits showing what was covered.

Patient Responsibility

You’re responsible for:

  • Copayments at the time of service
  • Deductibles before insurance coverage begins
  • Treatments not covered by your insurance plan
  • Amounts exceeding your annual maximum

Billing Statements

Monthly statements are sent for any outstanding balances. Statements include detailed treatment information and payment instructions. We offer online billing and payment options for your convenience.

Pre-Treatment Estimates

Treatment Cost Estimates

Before beginning any treatment, we provide detailed cost estimates that include:

  • Total treatment cost
  • Estimated insurance coverage
  • Your expected out-of-pocket expense
  • Payment plan options

Pre-Authorization

For major treatments, we can obtain pre-authorization from your insurance company to confirm coverage and avoid surprises. This process typically takes 1-2 weeks but provides peace of mind about coverage.

Treatment Planning

We work with you to prioritize treatments based on your child’s needs and your budget. Urgent treatments are addressed first, while elective procedures can be scheduled according to your financial preferences.

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Orthodontic Coverage

Orthodontic Benefits

Not all insurance plans include orthodontic coverage. We’ll verify your orthodontic benefits and explain:

  • Lifetime maximum benefits
  • Age restrictions
  • Waiting periods
  • Coverage percentages

Orthodontic Payment Plans

We offer special payment plans for orthodontic treatment, including:

  • No down payment options
  • Monthly payment plans
  • Family discounts for multiple children
  • Extended payment terms

Special Circumstances

Emergency Treatments

We understand dental emergencies can’t be planned financially. We offer emergency payment plans and work with families to ensure children receive necessary urgent care.

Second Opinions

If you’re seeking a second opinion, we can work with your insurance company to ensure coverage for consultations and examinations.

Changing Insurance Plans

If you change insurance plans during treatment, notify us immediately. We’ll help coordinate with your new provider to ensure continued coverage.

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Financial Assistance

Hardship Programs

We offer financial assistance programs for families experiencing financial hardship. These programs may include:

  • Reduced fees for essential treatments
  • Extended payment plans
  • Sliding scale fees based on income

Community Programs

We participate in various community programs that provide dental care for underserved populations. Ask our team about available programs in your area.

Charity Care

Limited charity care is available for families who qualify. Applications are reviewed on a case-by-case basis, and priority is given to urgent dental needs.

Frequently
Asked Questions

What if my insurance doesn't cover a recommended treatment?

We’ll discuss alternative treatments and payment options to ensure you receive the necessary care.

Most plans allow you to choose your provider, though some plans require referrals or have network restrictions.

We offer discounted fees for uninsured patients and flexible payment plans to make care affordable.

Our team will verify your benefits and provide detailed explanations of your coverage before treatment.

Yes, we can adjust payment arrangements as needed to accommodate your changing circumstances.