Office Policies

We strive to provide exceptional dental care for your children in a friendly, collaborative and fun environment. As parents, and those who work with children, we understand how hectic schedules can become juggling work, activities, children and more – which is why we strive to be as flexible as possible.

Scheduling Appointments at a dentist for kids

We do our best to schedule appointments at your convenience and when time is available on the schedule.

If something comes up and you are no longer able to keep your scheduled appointment, please notify our office 48 hours before your scheduled appointment time. For more details on this, please visit our cancellation policy.

Tips:

• Young children often do their best first thing in the morning, when they have more excitement for their day. It also allows us to work at their speed, ensuring we have plenty of time for their appointment.
• School aged children who are having dental work performed outside of a routine visit often do well with coming in the morning.

Separation: Kids Dentist Edition

You are welcome to stay with your child during the initial examination. We want to establish a trusting, comfortable relationship with your child and hope they eventually want to go back to the clinic area on their own. For the safety and privacy of all patients, other children who are not being treated should remain in the waiting area with a supervising adult.

In-Network Dental Insurance

We are in-network with the majority of dental insurance options.

• Delta Dental (all states)
• Cigna (PPO only, no HMO)
• Aetna
• Guardian
• GEHA
• Principal
• United Healthcare
• United Concordia
• United Concordia- Tricare
• Beam
• Unum

If you don’t see your insurance listed, we recommend you check with them to see if Mountain Kids Pediatric Dentistry is covered under your policy.

Dental Insurance Claims

We are happy to file your claim for you if your insurance is one of our in-network options. In order to do so, please provide your insurance information at least one day before your appointment.

We recommend that you look into your individual dental insurance policy to best understand your coverage. We will provide you with estimates for any dental work to be performed during your appointment. By law your insurance company is required to pay each claim within 30 days of receipt. We are not responsible for how your insurance company handles its claims or for what benefits they pay on a claim. We can only assist you in estimating your portion of the cost of treatment, we at no time guarantee what your insurance will or will not do with each claim.

We file all insurance claims electronically, which ensures your insurance receives the claim within days of treatment. You are responsible for any balance on your account after 60 days, whether insurance has paid or not. If your insurance ends up paying after you’ve paid the balance, we will send you a refund for the amount you paid in excess of insurance coverage.

Please keep us up to date with your current insurance plan – including any changes to the names of those covered, employer, policy name, policy number, and insurance company address.

Interesting Facts About Dental Insurance

No Insurance Pays 100% of 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. Unfortunately this is not true. The percentage paid by your insurance company 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.

Deductibles and Co-Payments Must Be Considered

When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary (UCR) 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 procedure. 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).

Benefits Are Not Determined By Our Office

Insurance companies set their own fee 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 arbitrarily chooses a level they call the “allowable” UCR Fee. Frequently this data can be three to five years old and these “allowable” fees are set by the insurance company so they can make a net 20%-30% profit.

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