LPD SAVINGS PLAN
We are excited to offer a dental savings plan for patients without dental insurance or for patients looking for a better alternative. We understand that traditional dental insurance premiums are expensive, and that insurance benefits are extremely limited on most plans so we have created a Dental Savings Plan to give our patients the kind of dental benefits they want and need.There are no deductibles, waiting periods, or restrictions on treatment. Patients generally see approximately 15% savings on dental exams, radiographs (x-rays) and treatment. For an annual fee ranging from $199-499 depending on the child's age, two wellness visits are included. Our plan may even make sense for patients with insurance who have high deductibles or self pay plans or even as a replacement for traditional dental insurance.
Now you can afford excellent dental care for your children. Call our office today at 703-726-3030 to learn more.
We are in network with several dental PPO’s. We are specifically out of network with United Concordia and Dr. Mike is out of network with Metlife. If you are a prospective patient and want to make sure we are in network, we ask that you call your insurance company to verify that our office is listed as a provider. We require that you bring your insurance card to each appointment. If your insurance does not send you a card, please go on the insurance company’s website and print out a card or the policy details such as subscriber name, subscriber ID, group name and group policy and bring that with you to your appointment.
Many medical insurance plans now carry a pediatric dental rider. This insurance must be billed prior to the dental insurance. Please check with your medical insurance to see if it carries this pediatric dental rider. If so, we will need the medical insurance information in order to file your claims.
We are happy to file your claims as a courtesy. We are not required to file claims even if it is with an insurance company we participate with. In order for us to file claims it is vital that we receive the most current insurance information. Claims that are older than 45 days will be closed and you will be responsible for the full amount.
Insurance is a contract between your employer and the insurance company. We were not involved in that negotiation, nor can we know the benefits and limitations of the many insurance plans on the market. Your insurance company is not required to provide us information about your coverage and benefits, even if we are in network with them. We urge you to understand your policy and to provide us with accurate information so that we can submit claims in a timely fashion and minimize your possible expenses. Claims older than 45 days will be closed and the balance will become your responsibility.
Any balance owed after insurance has paid is due immediately upon receipt of a statement from us. Any questions regarding the balance should first be addressed by reviewing the explanation of benefits (EOB) you receive from your insurance company. If it is unclear, then please call your insurance company for clarification. If you find there is an error on your statement after checking the EOB and consulting your insurance company, then please call our office.
Dr Gazori is not in network with Metlife Dental. Our associate dentists, Dr's Sumana Kafle, Tatiana Staver, and Nadgie Ortiz-Diaz continue to be in network with Metlife. What this means is that your diagnostic and preventive procedures will be considered out of network and treatment for cavities will be considered in network.
We have attached a list of MetLife group numbers here and percentage coverage levels for preventive and diagnostic services. These percentages were obtained through an automated Metlife system and may or may not be accurate. Also, you may have a deductible that will need to be met in some cases when you see an out of network provider. We advise you to call MetLife and utilize our insurance benefit form to verify your coverage benefits and limitations.
This does not mean that you have to find a new dentist for your child. It also does not mean you have to pay out of pocket at your child’s visit. We will continue to send the claims to Metlife and will send you a statement if there is a balance after insurance has paid. Depending on how your particular plan addresses out of network status may mean one of several things. It is possible that your plan does not cover out of network providers. This is not likely. It is possible that your plan does allow you to go out of network but that you have a higher copay. It is also possible that your preventive and diagnostic services will continue to be covered as they always have been. Common procedure codes are on the form so that you can provide these to Metlife when calling. Additionally, if your plan does not cover out of network providers, you could consider switching to another plan if allowed at your open enrollment.
The reason for this change is that we have found that our business model of conservative, preventive dentistry is not sustainable with the reimbursement levels that some insurance companies provide. We simply do not do unnecessary procedures for the purpose of revenue, such as cleanings and fluoride on toddlers unless necessary, or unnecessary x-rays.
We are happy to offer Care Credit for balances over $500. Please inquire about this option, which may include interest free payment options