Insurance Information

At Beaver Creek Endodontics we make every effort to provide you with the finest care and the most convenient financial options. We are not contracted or “in-network” with any insurance company but we are happy to submit services rendered to your carrier for payment. At your initial appointment we will provide an estimate of what your insurance may cover. We make every effort to be as accurate as possible in our quote. Insurance companies review each case independently so a general coverage percentage is all that is provided to our office and the quote we provide is calculated based on that percentage. The estimated patient portion and any co-pays or deductibles are due the day of treatment unless other arrangements have been made prior to your appointment.

Below are the answers to a few frequently asked questions.If you have additional questions feel free to call our office at (970) 748-6961. Please bring your insurance information with you to your first appointment so that we may expedite reimbursement.

FAQ’s

Why was my benefit different from what I expected?

Your dental benefit may vary for a number of reasons, such as:

• You have already used some or all of the benefits available.
• Your insurance plan paid only a percentage of the fee charged by our office.
• The treatment needed was not a covered benefit.
• You have not met your deductible.
• You have not reached the end of your plan’s waiting period and are currently ineligible for coverage.

Why isn’t the recommended treatment a covered benefit?

Beaver Creek Endodontics practices conservative dentistry and only recommends necessary treatments. We are cognoscente of our patients’ financial needs and concerns, nevertheless, Dr. Lee diagnoses and provides treatment based on his professional judgment and not the cost of that care. Some employers or insurance plans exclude coverage for necessary treatment as a way to reduce their costs. Your plan may not include this particular treatment or procedure although Dr. Lee deemed that treatment necessary.

What is a “UCR” and how is it determined?

“UCR” is the term used by insurance companies to describe the amount they are willing to pay for a particular endodontic procedure. There is no standard fee or accepted method for determining the UCR, and the UCR has no relationship to the fee charged by your endodontist. The administrator of each dental benefit plan determines the fees that the plan will pay, often based on many factors including region of the country, number of procedures performed and cost of living.

How do I know what my payment portion will be if my insurance does not cover the entire fee?

Your payment portion will vary according to the UCR of your plan, your maximum allowable benefit and other factors. Ultimately, the patient portion is not known until the insurance check has been received in our office.

How do I understand my Explanation of Benefits (EOB)?

Your Explanation of Benefits (EOB) contains a wealth of information. The EOB identifies benefits, the amount your insurance carrier is willing to pay and charges that are and are not covered by your plan. The statement includes the following information:UCR, copayment amount/patient portion, remaining benefits, deductible and benefit paid.