Frequently Asked Questions
Why yes, yes they are!
These are terms used to describe the amounts the insurance companies make up as charges for a specific procedure. These rarely reflect true numbers. Unfortunately, these numbers make it seem like the doctor is charging more than they should. Fortunately for our patients, Dr. Merlino had an independent study done on what the most common charges are for specific procedures in the area. Her charges were much lower than the 40th percentile (as low as the study showed.) Therefore, as a patient of Dr. Merlino, you can be sure that you will not be taken advantage of financially. The study is available upon request.
Each policy is different. Some procedures may or may not be covered. Some may be covered at a lower percentage than others. To be sure of your coverage, feel free to request a copy of your policy’s benefit schedule from your insurance carrier. For larger procedures such as crowns, partials, dentures, root canals, deep cleaning, etc., we will try to find out for you just what your insurance will pay. This may mean a phone call or sending a pre-determination. At times, we may need you to call or check with your employer or insurance company. If we find that a procedure is not covered and that you will be responsible for the whole amount, we promise to work with you so you will be able to have the necessary work done. No matter what type of insurance you have, you are responsible for the whole amount. If a procedure is done and your insurance does not pay us, you are responsible and will be asked to pay for the work done. We try not to let this be a surprise but sometimes insurance companies surprise us. They have changed their policies and have stopped paying for things that they have covered in the past. Some policies do not cover white (composite) fillings in back teeth. As a patient you are responsible for knowing your coverage. If you have a copy of your policy’s benefit schedule please bring it in to the office, fax it, or email it. It MAY help to reduce the guesswork.
An HMO is not insurance and we do not take any HMOs. Many of the state assistance programs fall into this category. If in doubt, call your insurance company directly. If they tell you that you MUST see a doctor on their list, then it is probably an HMO. Insurance usually gives you the freedom to go to any dentist you choose.
A discount program is not insurance. You must go to a dentist on their list. These are the types you see advertised on a telephone pole.
The real determining factor is your mouth! If you are cavity prone or like to chew ice, popcorn, or hard candy, then it is probably worth it. If you are blessed with good dental genes and take care of your teeth well, and you rarely need a filling, then it depends on what your monthly payment is. Two cleanings and exams annually and x-rays every few years will be around $200 per year. If your dental insurance costs you more than $20 per month per person, then you may want to reconsider carrying insurance.
For existing patients, we are willing to make financial arrangements to allow for patients to get dental work completed and make payments. For new patients, payment for service and copays is expected at the time of service. Payment plans are typically planned and agreed upon prior to treatment.