Questions About Lip/Tongue Tie? We Treat Infants & Toddlers Request Appointment

338 Plantation Street Worcester, MA 01604

Children's Dental Specialties Payment & Dental Insurance

Payment for professional services is due at the time dental treatment is provided. Every effort will be made to provide a treatment plan that fits your timetable and budget and gives your child the best possible care. We accept cash, personal checks, debit cards, Care Credit financing, and most major credit cards.

If we receive all your insurance information on the day of the appointment, we will be happy to file your claim. You must be familiar with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay. Your insurance company is required to pay each claim within 30 days of receipt.

Additional Payment and Insurance Information

We file all insurance electronically, so your insurance company will receive each claim within days of the treatment. You are responsible for any balance on your account after 30 days, whether insurance has been paid or not. We will be glad to provide a credit or send you a refund if the insurance overpays.

Please understand that we file insurance claims as a courtesy to our patients. We are not responsible for how your insurance company handles its claims or for what benefits they pay on a claim. Our team can only assist you in estimating your portion of the cost of treatment.

We at no time guarantee how your insurance will process each claim. Our office also can not be responsible for any errors in filing your claim. Once again, we file claims as a courtesy and will gladly assist you through this process.

Most importantly, please inform us of any insurance changes that may affect your claims, such as policy name, insurance company address, or a change of employment.

An Important Note About Insurance

Our in network status has changed. If you have questions about your dental insurance coverage, please contact us at (508) 756-6264.

In-Network Insurance Plans 

Out-of-Network But Accepted

No Insurance Pays 100% of All Procedures.

Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 90%-100% of all dental fees. This is not true! Most plans only pay between 50%-80% of the average total fee.

Some pay more; some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage or the type of contract your employer has set up with the insurance company.

Our Office Does Not Determine Benefits

You may have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist’s actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist’s fee has exceeded the usual, customary, or allowable fee (UCR) used by the company.

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable or well above what most dentists in the area charge for a certain service. This can be very misleading and simply is not accurate.

Insurance companies set their own schedules, and each company uses a different set of fees they consider allowable. These allowable fees may vary widely because each company collects fee information from claims it processes.

The insurance company then takes this data and then chooses a level they call the “allowable UCR½ fee. Frequently, this data can be many years out of date as the insurance company sets these allowable fees.

Unfortunately, insurance companies imply that your dentist is “overcharging” rather than say that they are “underpaying” or that their benefits are low. In general, the less expensive insurance policy will use a lower UCR figure.

Deductibles and Co-Payments

When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for a service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary fee, we can figure out what benefits will be paid.

First, a deductible (paid by you), on average $50, is subtracted, leaving $100.00. The plan then pays 80% for this particular service. The insurance company will then pay 80% of $100.00, or $80.00.

Out of a $150.00 fee, they will pay an estimated $80.00, leaving a remaining portion of $70.00 (to be paid by the patient). Of course, if the UCR is less than $150.00 or your plan pays only 50%, then the insurance benefits will also be significantly less.