At Charleston Oral and Facial Surgery we make every effort to provide you with the finest surgical care and the most convenient financial options. To accomplish this goal, we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures.
It is your responsibility to be aware of your policy’s benefits. We charge the usual and customary fees. You are responsible for payment regardless of the insurance company’s determination of usual and customary fees. If your insurance company has not responded with payment in 45 days from the date of service, you will receive a bill for payment. Any balance over 60 days is subject to a 2% monthly finance charge.
Insurance Frequently Asked Questions:
What is a contracted provider (in network)?
Being a contracted provider means that we have entered into a contract with certain insurance companies to provide services at a set price. This allows you to receive a lower fee for the provided service and ensure that they (the insurance company) will cover the procedures that we provide. By accepting these insurance plans, it greatly reduces your out-of-pocket expense and allows for an accurate estimate of cost. Additionally, the insurance companies will often cover a higher percentage of the fee versus a non-contracted provider (out off network).
What is a non-contracted provider (out of network)?
A non-contracted provider means that your insurance company does not have a set fee schedule with us. This does not mean that they will not cover your procedure, it only means that they will only pay a certain amount towards our customary fees and the patient is responsible for the difference. We work with you and all non-contracted providers to maximize your insurance benefits in order to reduce your out of pocket expense. However, please understand that if the insurance company decides not to pay for a procedure or decides that it will only pay a minimal amount, you are responsible for the difference.
How will Charleston Oral and Facial Surgery help me with insurance coverage and benefits?
At your appointment, we will contact the insurance company and provide them with your treatment plan and all necessary codes. They will then tell us what procedures are covered, the amount that they will pay, and provide us with a list of your benefits. You are then responsible for only the amount the insurance company will not cover. Those insurances that are contracted providers (in network) will allow for a much more accurate determination of benefits and cost. On occasion, they will pay less than anticipated, and you will be responsible for the difference. If they pay more than anticipated we will refund you the credit.
Do I have to pay the entire fee upfront?
No. Once we contact the insurance company and they tell us what they will pay, we count that toward your balance and submit a claim on your behalf. Please provide us with all the accurate information to aid in submitting your claim and maximizing your insurance benefits. You are only responsible for the amount that is not covered at the time of surgery. If, however, they do not pay the amount that they said they would, you will be sent a bill. If they pay more, we will refund you the credit.
If you do not have insurance benefits, then you will be responsible for the entire fee at the time that services are rendered.
We accept the following:
- Aetna Dental
- BCBS State Dental Plus
- BCBS State Basic
- BCBS Medical
- BCBS Federal
- BCBS Dental
- Delta Dental
- Thomas Cooper
- Veterans Affairs
- United Concordia
- Worker’s Compensation