Pediatric dentist - Dr. Evelyn Rolon
Pediatric dentist - Dr. Evelyn Rolon - Office Policies

How are appointments scheduled?    |    Do I stay with my child during the visit?
What about finances?    |    Our Office Policy Regarding Dental Insurance

 

group of smiling kids 

How are appointments scheduled?

We strive to see all patient’s on time for their scheduled appointments.  We value your time and will do our best to keep you from having to wait.  But please remember, we run on children time, not adult time.  Each child is an individual, and some may require more “tender loving care” than others.  There are times when our schedule is delayed in order to accommodate an injured child or an emergency.  Please accept our apology in advance should this occur during your appointment.  We ask for your patience, and that you keep in mind your child may be the next one needing your extra attention.

  • Each visit is unique, but generally the first appointment consists of an examination, cleaning, x-rays, and a fluoride treatment.  Dental x-rays are necessary to accurately diagnose treatment.  Based on the examination by Dr. Evelyn Rolon, your child may require additional appointments.
  • As a rule, treatment is not scheduled or performed on the first appointment.  Patient’s referred to the office by another dentist will require an examination, x-rays, and a proper diagnosis by Dr. Evelyn Rolon.
  • Preschool children should be seen in the morning because they are fresher and we can work more slowly with the child for their comfort.  School children with a lot of work to be done should be seen in the morning for the same reason.
  • Your scheduled appointment time is reserved specifically for your child.  As a courtesy, the office will make every attempt to contact you by email and/or by phone for a reminder call 1-2 days prior to the appointment.  Due to the high volume, we do require a reminder call in order to hold your child’s reserved appointment time.
  • Your prompt arrival for scheduled appointments is greatly appreciated.  We realize there could be a situation preventing you from arriving on time.  Every effort will be made to accommodate your child, but please understand if you arrive 10 or more minutes late you may be asked to reschedule to the next available appointment time.
  • If a cancellation is unavoidable, please notify the office at least 24 hours in advance.  Broken appointments or short term cancellations can be costly and unfair to other patients who need appointments.  Repeated broken or missed appointments could cause dismissal from the practice.

Do I stay with my child during the visit?

We ask that you allow your child to accompany our staff through the dental experience. We are all highly experienced in helping children overcome anxiety. Separation anxiety is not uncommon in children, so please try not to be concerned if your child exhibits some negative behavior. This is normal and will soon diminish. Studies and experience have shown that most children over the age of 3 react more positively when permitted to experience the dental visit on their own and in an environment designed for children.

What about finances?

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

Our Office Policy Regarding Dental Insurance

If we have received all of your insurance information on the day of the appointment, we will be happy to file your claim for you. You must be familiar with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay. By law your insurance company is required to pay each claim within 30 days of receipt. 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 paid or not. If you have not paid your balance within 60 days a re-billing fee of 1.5% will be added to your account each month until paid. We will be glad to send a refund to you if your insurance pays us.

 

PLEASE UNDERSTAND that we file dental insurance as a courtesy to our patients. We do not have a contract with your insurance company, only you do. 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 also can not be responsible for any errors in filing your insurance. Once again, we file claims as a courtesy to you.

 

Fact 1 - 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.

 

Fact 2 - BENEFITS ARE NOT DETERMINED BY OUR OFFICE
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 reasonable 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 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.

 

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 usual, customary, or reasonable (UCR) figure.

 

Fact 3 - DEDUCTIBLES & 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). Of course, if the UCR is less than $150.00 or your plan pays only at 50% then the insurance benefits will also be significantly less.

 

MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.

 

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Pediatric Dentist, Abingdon, VA - Dr. Evelyn Rolon